Organization
MEDICAL DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO R CONTRERAS MD (MEDICAL DIRECTOR)
(765) 446-7201
Entity
Organization
Contact information
Practice address
2400 SOUTH STREET, DEPARTMENT OF PATHOLOGY, LAFAYETTE, IN 47903
(765) 446-7201
(765) 448-2921
Mailing address
18650 W CORPORATE DRIVE, SUITE 200, BROOKFIELD, WI 53045
(262) 641-5143
(262) 641-6880
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/02/2007
Last updated
08/22/2020
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