Organization
AMERICAN DERMATOPATHOLOGY LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN NICHOLAS SHAMMA MD (OWNER)
(937) 602-4322
Entity
Organization
Contact information
Practice address
210A E SPRING VALLEY PIKE, DAYTON, OH 45458-2653
(937) 412-4230
(937) 482-0542
Mailing address
210A E SPRING VALLEY PIKE, DAYTON, OH 45458-2653
(937) 412-4230
(937) 482-0542
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
05/01/2014
Last updated
04/01/2015
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