James  P  Bodnar    MD
Contract Details
AmeriPath
Facility name
Provider ID
P000006705
NPI
1437139326
Tax ID
562097663
Effective Date
5/16/2012
Last Updated
9/25/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
Medical Services Building 568 Ruin Creek Road, Suite 5
Henderson, NC 275365921
United States
County
Vance
Phone
2524924477 (Phone)
Billing Details
Address
PO Box 198986
Atlanta, GA 303848986
Billing Phone
9723854928
Specialty Type
Pathology, Clinical
Map
Address