MEDICARE: DERMATOPATHOLOGY SERVICES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0415028	KS
2	207ZD0900X	Dermatopathology (Pathology) Physician	0415028	KS

General Provider Information

NPI Number	:	1437282407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMATOPATHOLOGY SERVICES PA

Provider Business Mailing Address
First Line	:	3514 CLINTON PKWY
Second Line	:	STE A #421
City	:	LAWRENCE
State	:	KS
Zip	:	66047-2145
Country	:	US
Telephone Number	:	785-249-2860
Fax Number	:	800-878-1139

Provider Business Practice Location Address
First Line	:	3514 CLINTON PKWY
Second Line	:	STE A #421
City	:	LAWRENCE
State	:	KS
Zip	:	66047-2145
Country	:	US
Telephone Number	:	785-249-2860
Fax Number	:	800-878-1139

Authorized Official
Title or Position	:	PRESIDENT OF CORPORATION
Name	:	DR. DAVID M BOREL
Credential	:	MD
Telephone Number	:	785-249-2860

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	09/11/2025

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