Diagnostic Services of Washington County SC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

31307 Issued in WI

Legal business name

DIAGNOSTIC SERVICES OF WASHINGTON COUNTY SC

Practice address

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Phone

(262) 334-8287

Fax

(262) 334-8497

NPI assigned

Feb 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John G Fink, MD

Title

President

Phone

(262) 334-8287

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1639145576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100559",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010559",
            "telephone_number": "843-664-4300",
            "fax_number": "843-664-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-334-8287",
            "fax_number": "262-334-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC SERVICES OF WASHINGTON COUNTY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "FINK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-334-8287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "31307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32870100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Anne Dieringer, MPT
• Ajit B Divgi, MD
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• Anatomic Pathology & Clinical Pathology Physician in West Bend, WI
• Providers in West Bend, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.