# MOSAIC GASTROINTESTINAL PATHOLOGY SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023038536
- **Authorized official:** DR. JULIA DAHL MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (901) 850-3582

## Contact information

- **Practice address:** 1318 MARSH CREEK LN, COLLIERVILLE, TN 38017-3940
- **Practice address phone:** (901) 850-3582
- **Practice address fax:** (866) 359-8798
- **Mailing address:** 1318 MARSH CREEK LN, COLLIERVILLE, TN 38017-3940
- **Mailing address phone:** (901) 850-3582
- **Mailing address fax:** (866) 359-8798

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | 26678 | TN | Yes |
| 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