Organization
DIAGNOSTIC DERMATOPATHOLOGY
Active
Organization
DIAGNOSTIC DERMATOPATHOLOGY
Active
Other names
Diagnostic Dermatopathology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LIAQAT ALI MD (OWNER)
(706) 256-1133
Entity
Organization
Contact information
Practice address
2101 BROOKSTONE CENTRE PKWY, STE 300, COLUMBUS, GA 31904-9254
(706) 256-1133
(706) 256-1136
Mailing address
2101 BROOKSTONE CENTRE PKWY, STE 300, COLUMBUS, GA 31904-9254
(706) 256-1133
(706) 256-1136
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
74802
GA
207ND0900X
Dermatopathology Physician
Primary
74802
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003171345A
—
GA
Enumeration date
12/11/2015
Last updated
01/11/2017
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