Basic Information
| Provider Information | |||||||||
| NPI: | 1285633230 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO VALLEY PATHOLOGY ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2070 | ||||||||
| Address2: | |||||||||
| City: | WEIRTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260621270 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4000 JOHNSON RD | ||||||||
| Address2: | TRINITY MEDICAL CENTER WEST | ||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402648188 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2005 | ||||||||
| LastUpdateDate: | 10/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | DOSHI | ||||||||
| AuthorizedOfficialFirstName: | HIMANSHU | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7402648188 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 2274588 | 05 | OH | MEDICAID | CJ3653 | 01 | RAILROAD MEDICARE | OTHER | 0202852-000 | 05 | WV | MEDICAID |