Organization
PATHOLOGY SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT V RIDENOUR M.D. (PATHOLOGIST - PRESIDENT)
(715) 858-3260
Entity
Organization
Contact information
Practice address
3902 OAKWOOD HILLS PKWY STE 2, EAU CLAIRE, WI 54701-7781
(715) 858-3260
Mailing address
1235 MENOMONIE ST STE B, EAU CLAIRE, WI 54703-5974
(715) 832-6445
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0104X
Chemical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
207ZP0213X
Pediatric Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32692700
—
WI
Enumeration date
05/03/2006
Last updated
04/26/2025
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