Healthcare Provider Details

I. General information

NPI: 1437111655
Provider Name (Legal Business Name): MONROE PATHOLOGY ASSOC., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 NORTH MACOMB STREET
MONROE MI
48162-7815
US

IV. Provider business mailing address

PO BOX 1601
MONROE MI
48161-6601
US

V. Phone/Fax

Practice location:
  • Phone: 800-288-8325
  • Fax: 419-866-5453
Mailing address:
  • Phone: 800-288-8325
  • Fax: 419-866-5453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. NORMA CARZON
Title or Position: PRESIDENT
Credential: MD
Phone: 734-240-8400