Basic Information
| Provider Information | |||||||||
| NPI: | 1609323435 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED SIOUXLAND PATHOLOGISTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 W ANCHOR DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DAKOTA DUNES | ||||||||
| State: | SD | ||||||||
| PostalCode: | 570495335 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 350 W ANCHOR DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DAKOTA DUNES | ||||||||
| State: | SD | ||||||||
| PostalCode: | 570495335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6052324270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2016 | ||||||||
| LastUpdateDate: | 09/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | QALBANI | ||||||||
| AuthorizedOfficialFirstName: | ASKAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7122510148 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0105X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine |
No ID Information.