1659511822 NPI number — BIOPSY DIAGNOSTICS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659511822 NPI number — BIOPSY DIAGNOSTICS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIOPSY DIAGNOSTICS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659511822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
49 BROWNS COVE RD
Provider Second Line Business Mailing Address:
STE. 6
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29936-8182
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-379-2939
Provider Business Mailing Address Fax Number:
843-379-2949

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 MARSH POINT RD
Provider Second Line Business Practice Location Address:
STE. 303
Provider Business Practice Location Address City Name:
NEPTUNE BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-379-2939
Provider Business Practice Location Address Fax Number:
843-379-2949
Provider Enumeration Date:
03/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ZHU
Authorized Official First Name:
WEIJIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
843-379-2939

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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