Organization
INTEGRATED DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAUMAN NISAR MD (OWNER/DIRECTOR)
(712) 389-5242
Entity
Organization
Contact information
Practice address
201 E 4TH ST STE 203, SOUTH SIOUX CITY, NE 68776-1706
(712) 389-5242
Mailing address
425 BAYHILL CIR, DAKOTA DUNES, SD 57049-5092
(712) 389-5242
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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