Provider Demographics
NPI:1386600054
Name:MOUNTAIN AREA PATHOLOGY PA
Entity type:Organization
Organization Name:MOUNTAIN AREA PATHOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-253-0762
Mailing Address - Street 1:PO BOX 17056
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7056
Mailing Address - Country:US
Mailing Address - Phone:866-457-5162
Mailing Address - Fax:919-967-6647
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-253-0762
Practice Address - Fax:828-254-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02737OtherBCBS NC
NC7902737Medicaid
NCCK4248OtherRAILROAD MEDICARE
NC7902737Medicaid