Kent Pathologists PLLC
Pathology, Anatomic Pathology & Clinical Pathology in Grand Rapids, MI. Organization (NPI-2).
NPI number1194774729
StatusActive
Last updated in NPPESAug 7, 2007
Details
- NPI
- 1194774729
- Entity type
- Organization (NPI-2)
- Legal business name
- Kent Pathologists PLLC
- Organization subpart
- No
- Enumeration date
- May 10, 2006
- Last updated
- Aug 7, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | – | – | Yes |
| 207ZD0900X | Pathology, Dermatopathology | – | – |
Practice location
200 Jefferson SeSt Marys Health Service Pathology Dept
Grand Rapids, MI 49503-4502
Phone 616-774-0209
Mailing address
2650 Horizon Dr SeSuite B
Grand Rapids, MI 49546-7519
Authorized official
Won Kyu Lee
Medical Director Member
6167740209
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