Individual
AHMED FAHAD LAZIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(512) 707-2000
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(215) 707-2000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MT220369
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/24/2020
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