Healthcare Provider Details

I. General information

NPI: 1427012012
Provider Name (Legal Business Name): CELESTE BATCHEV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 N MACOMB ST
MONROE MI
48162-7815
US

IV. Provider business mailing address

PO BOX 1601
MONROE MI
48161-6601
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-8400
  • Fax:
Mailing address:
  • Phone: 734-240-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number4301061158
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: