Healthcare Provider Details

I. General information

NPI: 1629121942
Provider Name (Legal Business Name): INTEGRATED PATHOLOGY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 W INDIAN SCHOOL RD BLDG 6 SUITE 122
PHOENIX AZ
85037
US

IV. Provider business mailing address

PO BOX 14690
PHOENIX AZ
85063
US

V. Phone/Fax

Practice location:
  • Phone: 623-889-0100
  • Fax: 623-889-0101
Mailing address:
  • Phone: 623-889-0100
  • Fax: 623-889-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR SITELMAN
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 623-889-0100