Provider Demographics
NPI:1134285463
Name:DIAGNOSTIC PATHOLOGY LABORATORIES, INC
Entity Type:Organization
Organization Name:DIAGNOSTIC PATHOLOGY LABORATORIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIGUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-879-6866
Mailing Address - Street 1:2005 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2621
Mailing Address - Country:US
Mailing Address - Phone:410-879-6866
Mailing Address - Fax:
Practice Address - Street 1:2005 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2621
Practice Address - Country:US
Practice Address - Phone:410-879-6866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW455DIOtherBLUE SHIELD
DCT325OtherGHI
MDW455Medicare PIN
MDCI1353Medicare PIN