Healthcare Provider Details

I. General information

NPI: 1659240158
Provider Name (Legal Business Name): BEYOND PROFESSIONAL PATHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44400 VAN DYKE AVE STE 102A
STERLING HEIGHTS MI
48314-2370
US

IV. Provider business mailing address

44400 VAN DYKE AVE STE 102A
STERLING HEIGHTS MI
48314-2370
US

V. Phone/Fax

Practice location:
  • Phone: 248-818-4925
  • Fax:
Mailing address:
  • Phone: 248-818-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MANSI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 248-818-4925