Provider Demographics
NPI:1770889891
Name:UNIVERSITY PATHOLOGY ASSOCIATES, PLC
Entity type:Organization
Organization Name:UNIVERSITY PATHOLOGY ASSOCIATES, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-244-0162
Mailing Address - Street 1:3050 BERKMAR DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-3405
Mailing Address - Country:US
Mailing Address - Phone:434-244-0162
Mailing Address - Fax:434-244-0153
Practice Address - Street 1:3050 BERKMAR DR STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3405
Practice Address - Country:US
Practice Address - Phone:434-244-0162
Practice Address - Fax:434-244-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA30-F-001291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory