Healthcare Provider Details

I. General information

NPI: 1194953810
Provider Name (Legal Business Name): GLOBAL DERMATOPATHOLOGY SERVICES, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14019 S 8TH ST
PHOENIX AZ
85048-4459
US

IV. Provider business mailing address

1241 JOHNSON AVE MAIL BOX 312
SAN LUIS OBISPO CA
93401-3306
US

V. Phone/Fax

Practice location:
  • Phone: 408-668-3737
  • Fax: 480-699-9383
Mailing address:
  • Phone: 480-668-3737
  • Fax: 480-699-9383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. IFTIKHAR AHMED
Title or Position: DIRECTOR AND OWNER
Credential: M.D.
Phone: 480-668-3737