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NPI Code Detail

MEDICARE: WESTERN MICHIGAN PATHOLOGY ASSOCIATES, LLC

MEDICARE: WESTERN MICHIGAN PATHOLOGY ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number : 1053394080
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN MICHIGAN PATHOLOGY ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 602 MICHIGAN AVE
Second Line :
City : HOLLAND
State : MI
Zip : 49423-4918
Country : US
Telephone Number : 616-392-5141
Fax Number : 419-866-5453
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : MATTHEW DAVID CARR
Credential :
Telephone Number : 800-288-8325
Provider Enumeration Date : 11/23/2005
Last Update Date : 05/21/2026

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Directions to “WESTERN MICHIGAN PATHOLOGY ASSOCIATES, LLC ” Practice Location

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