Minnesota Pathologists Chartered

Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Willmar, MN

NPI 1992851315 · NPPES record last updated Oct 30, 2013

Key facts

NPI
1992851315
Entity type
Organization (NPI type 2)
Primary specialty
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
License
PF 259 (MN)
Legal business name
MINNESOTA PATHOLOGISTS CHARTERED
Practice address
301 Becker Ave SW
Willmar, MN 56201-3302
Phone
(320) 231-4500
Fax
(320) 231-4503
NPI assigned
Jan 26, 2007
Organization subpart
No

Authorized official

Name
Lee L Cafferty, MD, MD
Title
Ceo
Phone
(320) 231-4500

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 61

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070509000225 MN Part B Supplier - Clinic/Group Practice 7911003835 Receives reassigned benefits from 4 practitioners
Practice locations: Benson, MN; Litchfield, MN; Madison, MN; Montevideo, MN; Olivia, MN; Willmar, MN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207ZP0102X PF 259 MN Yes

Addresses

Primary practice location

301 Becker Ave SW
Willmar, MN 56201-3302

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other providers in Willmar, MN

All providers in Willmar, MN · Anatomic Pathology & Clinical Pathology Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.