MEDICARE: DIAGNOSTIC PATHOLOGY CONSULTANTS, LLPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1114988599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC PATHOLOGY CONSULTANTS, LLPC

Provider Business Mailing Address
First Line	:	13355 E 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48089-2048
Country	:	US
Telephone Number	:	586-759-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	13355 E 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48089-2048
Country	:	US
Telephone Number	:	586-759-7300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KAREN KANTOR
Credential	:	DO
Telephone Number	:	586-759-7569

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/22/2020

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