Provider Demographics
NPI:1679658751
Name:FREDERICK PATHOLOGY CONSULTANTS, PA
Entity Type:Organization
Organization Name:FREDERICK PATHOLOGY CONSULTANTS, PA
Other - Org Name:KUSUM A.R. KALAVAR, M.D., P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-360-2527
Mailing Address - Street 1:P.O. BOX 43130
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5915
Mailing Address - Country:US
Mailing Address - Phone:410-931-0400
Mailing Address - Fax:410-931-1009
Practice Address - Street 1:400 WEST SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4506
Practice Address - Country:US
Practice Address - Phone:240-566-3300
Practice Address - Fax:240-566-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCT134OtherGHI
MD459300600Medicaid
MDCG3312OtherRAILROAD MEDICARE
MDLM09OtherBLUE SHIELD
MD806LMedicare PIN