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Organization

MODERNPATH INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KHATIB JAFRI MD (PRESIDENT)
(330) 489-1000
Entity
Organization

Contact information

Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1000
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2565862
OH
Enumeration date
11/16/2005
Last updated
04/23/2012
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