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DR. KENNETH LEE SISCO M.D.

Anatomic Pathology & Clinical Pathology >> Pathology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1003937111

Individual Registrant:
DR. KENNETH LEE SISCO M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
11054 DOXBERRY CIR  WOODSTOCK, MD 21163-1499 US
Tel: 732-673-7050  Fax: 410-992-8185

Contact information for business:
11054 DOXBERRY CIR  WOODSTOCK, MD 21163-1499 US
Tel: 732-673-7050  Fax: 410-992-8185

Registration Information:
NPI: 1003937111
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207ZP0102XAllopathic & Osteopathic Physicians
Pathology
Anatomic Pathology & Clinical Pathology
CAG56601
Y207ZP0102XAllopathic & Osteopathic Physicians
Pathology
MDD0015918

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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