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Organization

PATHOLOGY LABORATORY MEDICINE CONSULTANTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEX P RACADAG MD (OWNER)
(304) 831-1555
Entity
Organization

Contact information

Practice address
20 HOSPITAL DR, LOGAN, WV 25601-3452
(304) 831-1555
Mailing address
PO BOX 1269, CHAPMANVILLE, WV 25508-1269

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810009387
WV
Enumeration date
09/06/2005
Last updated
11/12/2007
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