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NPI Code Detail

MEDICARE: SURGICAL PATHOLOGY CONSULTANTS, INC.

MEDICARE: SURGICAL PATHOLOGY CONSULTANTS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246QH0600XHistology Specialist/Technologist10975AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z3D0877316OTHERAZPTAN

General Provider Information

NPI Number : 1427117472
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGICAL PATHOLOGY CONSULTANTS, INC.
Provider Business Mailing Address
First Line : 5422 W THUNDERBIRD RD
Second Line : #13
City : GLENDALE
State : AZ
Zip : 85306-4700
Country : US
Telephone Number : 602-547-1024
Fax Number : 623-606-2458
Provider Business Practice Location Address
First Line : 5422 W THUNDERBIRD RD
Second Line : #13
City : GLENDALE
State : AZ
Zip : 85306-4700
Country : US
Telephone Number : 602-547-1024
Fax Number : 623-606-2458
Authorized Official
Title or Position : OFFICE MANAGER
Name : PHIL SAMPAIO
Credential :
Telephone Number : 602-547-1024
Provider Enumeration Date : 12/06/2006
Last Update Date : 05/06/2010

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Directions to “SURGICAL PATHOLOGY CONSULTANTS, INC. ” Practice Location

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