Provider Demographics
NPI:1598870800
Name:METRO SOUTH PATHOLOGY, INC.
Entity Type:Organization
Organization Name:METRO SOUTH PATHOLOGY, INC.
Other - Org Name:QUINCY PATHOLOGY ASSOCIATES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:KASIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-624-8397
Mailing Address - Street 1:1342 BELMONT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4438
Mailing Address - Country:US
Mailing Address - Phone:508-580-1670
Mailing Address - Fax:
Practice Address - Street 1:85 COLUMBIAN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2416
Practice Address - Country:US
Practice Address - Phone:781-624-8397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA701816OtherTUFTS HEALTH PLAN
MAA796OtherHARVARD PILGRIM
MAM14033OtherBCBS MA
MAM14033Medicare PIN
MA9741984Medicaid
MA000000005684OtherBMC HEALTH NET
MACD9606OtherRAILROAD MEDICARE