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General NPI Number Information
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NPI Number | 1427413103
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Entity Type | Organization
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Legal Business Name | ATLANTIS DIAGNOSTIC LABORATORIES LLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 24555 SOUTHFIELD RD SUITE L80
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2738
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Country | US
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Telephone | 947-282-6924
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9197
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City | COLLEGE STATION
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State | TX
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Zip | 77842-9197
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYED ALI KARIM
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Credential |
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Telephone | 947-282-6924
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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 |
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License Number State |
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