Organization
CROWN PATHOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M CARSON (BILLING AGENT)
(207) 764-7529
Entity
Organization
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4209
(207) 768-4013
Mailing address
PO BOX 1820, PRESQUE ISLE, ME 04769-1820
(207) 764-7529
(207) 764-6504
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
012546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003962
ANTHEM
ME
05
—
123680000
—
ME
01
—
220016505
RAILROAD MEDICARE GROUP #
ME
01
—
9482121
CIGNA GROUP #
ME
Enumeration date
07/23/2006
Last updated
09/22/2008
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