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NPI Code Detail

MEDICARE: TAWAS PATHOLOGISTS, PC

MEDICARE: TAWAS PATHOLOGISTS, PC
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 : 1114900073
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAWAS PATHOLOGISTS, PC
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 : 200 HEMLOCK ST
Second Line :
City : TAWAS CITY
State : MI
Zip : 48763-9237
Country : US
Telephone Number : 989-362-1047
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JAYA SANKARAN
Credential : MD
Telephone Number : 989-362-7515
Provider Enumeration Date : 11/23/2005
Last Update Date : 10/18/2013

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