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KAISER FOUNDATION HEALTH PLAN MID ATLANTIC STATES NPI 1568520070


NPI Information

NPI: 1568520070
Provider Name: KAISER FOUNDATION HEALTH PLAN MID ATLANTIC STATES

Doing Business As: PENDERBROOK MEDICAL CENTER LABORATORY

Classification: Pathology - 207ZP0102X
Entity Type: Organization

Specialization: Anatomic Pathology & Clinical Pathology

Address:
12011 LEE JACKSON HIGHWAY
FAIRFAX, VA
ZIP 22033
Phone: (703) 257-3050
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KAISER FOUNDATION HEALTH PLAN MID ATLANTIC STATES is an anatomic pathology and clinical pathology pathology in Fairfax, VA. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. KAISER FOUNDATION HEALTH PLAN MID ATLANTIC STATES NPI is 1568520070. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Penderbrook Medical Center Laboratory.

The provider's business location address is:

12011 LEE JACKSON HIGHWAY
FAIRFAX, VA
ZIP 22033-310
Phone: (703) 257-3050
Fax: (703) 257-3042

The provider's authorized official is Andee G Petersen .
The authorized official title is Cheif Financial Officer and has the following contact phone number (301) 816-5760.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 5/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ZP0102XPathologyAnatomic Pathology & Clinical PathologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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