| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Pathology |
| DEFINITION | A pathologist who specializes in the diagnosis of immunologic diseases. |
| AREA OF SPECIALIZATION | Immunopathology |
| STATUS | Active |
| VA CODE | V182410 |
| X12 CODE | 207ZI0100X |
| SPECIALTY CODE | 22 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5251523 |
| EFFECTIVE DATE/TIME |
|