Organization
PATHOLOGISTS DIAGNOSTIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CULLEN TAYLOR MD (PRESIDENT)
(336) 718-3771
Entity
Organization
Contact information
Practice address
3333 SILAS CREEK PARKWAY, WINSTON SALEM, NC 27103
(336) 718-3771
(336) 718-9259
Mailing address
P.O. BOX 30369, WINSTON SALEM, NC 27130
(336) 999-8888
(336) 999-8889
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
200000967
NC
207ZH0000X
Hematology (Pathology) Physician
22509
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
24810
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901926
—
NC
01
—
BCBS
01926
—
Enumeration date
03/10/2006
Last updated
11/24/2020
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