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General NPI Number Information
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NPI Number | 1265546899
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Entity Type | Organization
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Legal Business Name | HURON PATHOLOGY SERVICES PC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 S VAN DYKE
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City | BAD AXE
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State | MI
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Zip | 48413
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Country | US
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Telephone | 989-269-9521
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Fax | 989-269-7948
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Provider Business Mailing Address
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Address Line | PO BOX 102
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City | BAD AXE
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State | MI
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Zip | 48413-0102
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Country | US
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Telephone | 989-269-9819
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Fax | 989-269-5212
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN C LIAO
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Credential | MD
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Telephone | 989-269-9819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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