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General NPI Number Information
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NPI Number | 1841450269
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Entity Type | Individual
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Provider Name | DELARAM FATEMI MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 6500 38TH AVE N PATHOLOGY DEPT
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1629
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Country | US
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Telephone | 727-341-4874
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Fax | 727-341-4925
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Provider Business Mailing Address
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Address Line | PO BOX 741087
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City | ATLANTA
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State | GA
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Zip | 30384-1087
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Country | US
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Telephone | 727-341-4874
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Fax | 727-341-4925
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 59151
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME125772
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License Number State | FL
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