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General NPI Number Information
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NPI Number | 1104898873
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Entity Type | Organization
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Legal Business Name | DERMATOPATHOLOGY SERVICES INC
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 3918 MONTCLAIR RD SUITE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35213-2417
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Country | US
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Telephone | 205-870-4897
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Fax | 205-871-4709
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD SUITE 400
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City | ADDISON
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State | TX
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Zip | 75001-3614
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Country | US
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Telephone | 214-932-8029
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Fax | 610-271-4245
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. EDWARD M KRAMER
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Credential | M.D.
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Telephone | 610-550-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 01D0641513
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License Number State | AL
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