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General NPI Number Information
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NPI Number | 1174085799
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Entity Type | Individual
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Provider Name | LINDSEY KAITLYN DUROWOJU MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 200 JEFFERSON AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4502
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Country | US
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Telephone | 616-685-6258
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9186
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City | LONGVIEW
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State | TX
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Zip | 75608-9186
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Country | US
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Telephone | 903-663-4800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 4301513886
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License Number State | MI
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