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Organization
MOSAIC GASTROINTESTINAL PATHOLOGY SERVICES PLLC
Active
Organization
MOSAIC GASTROINTESTINAL PATHOLOGY SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIA DAHL MD (CHIEF EXECUTIVE OFFICER)
(901) 850-3582
Entity
Organization
Contact information
Practice address
1318 MARSH CREEK LN, COLLIERVILLE, TN 38017-3940
(901) 850-3582
(866) 359-8798
Mailing address
1318 MARSH CREEK LN, COLLIERVILLE, TN 38017-3940
(901) 850-3582
(866) 359-8798
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01061121A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0431573
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
043452
CT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
15159R
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
18432
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
236521
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
26678
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
27153
AL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
28383
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
38315
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5898862
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
DR-44161
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
L4321
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD35554
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD38561
WA
Other
Enumeration date
07/20/2006
Last updated
12/04/2008
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