Provider Demographics
NPI:1992726913
Name:DAHL CHASE PATHOLOGY ASSOCIATES P.A.
Entity type:Organization
Organization Name:DAHL CHASE PATHOLOGY ASSOCIATES P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-941-8200
Mailing Address - Street 1:417 STATE ST
Mailing Address - Street 2:SUITE 439
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6635
Mailing Address - Country:US
Mailing Address - Phone:207-941-8270
Mailing Address - Fax:207-990-4848
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:SUITE 439
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6635
Practice Address - Country:US
Practice Address - Phone:207-941-8270
Practice Address - Fax:207-990-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME207ZP0102X
207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME105060000Medicaid
MECK1230Medicare PIN
ME105060000Medicaid
ME152663Medicare PIN