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General NPI Number Information
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NPI Number | 1962430900
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Entity Type | Organization
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Legal Business Name | ROCHESTER PATHOLOGY PC
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1101 W UNIVERSITY DRIVE
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City | ROCHESTER
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State | MI
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Zip | 48307-1831
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Country | US
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Telephone | 248-652-5000
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Fax | 248-652-5605
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Provider Business Mailing Address
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Address Line | PO BOX 80275
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City | ROCHESTER HILLS
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State | MI
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Zip | 48308-0275
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Country | US
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Telephone | 248-652-5000
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Fax | 248-652-5605
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID L KLIONSKY
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Credential | MD
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Telephone | 248-652-5000
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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 |
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License Number State |
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