MEDICARE: PARADIGM DIAGNOSTICS 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
1	207ZC0500X	Cytopathology Physician
2	291U00000X	Clinical Medical Laboratory	32236	AZ
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1477898583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADIGM DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	445 N 5TH ST
Second Line	:	300
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2157
Country	:	US
Telephone Number	:	602-850-7006
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 N 5TH ST
Second Line	:	300
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2157
Country	:	US
Telephone Number	:	605-569-2997
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	KEVIN T CONROY
Credential	:
Telephone Number	:	608-284-5700

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	09/01/2020

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