Organization
SIOUXLAND PATHOLOGY GROUP SMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASKAR A QALBANI MD (DIRECTOR)
(712) 279-2052
Entity
Organization
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1394
(712) 279-2052
Mailing address
PO BOX 1463, SIOUX CITY, IA 51102-1463
(712) 279-2263
(712) 279-5631
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005921
WELLMARK BLUE CROSS SD
SD
05
—
0302661
—
IA
01
—
30266
WELLMARK BLUE CROSS
IA
05
—
31140722800
—
NE
Enumeration date
11/22/2005
Last updated
08/22/2020
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