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Organization
WESTERN PATHOLOGY CONSULTANTS, LTD
Active
Organization
WESTERN PATHOLOGY CONSULTANTS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRATTENDICK (CFO)
(561) 626-5512
Entity
Organization
Contact information
Practice address
343 ELM ST, SUITE 206, RENO, NV 89503-4522
(775) 746-3400
(775) 746-3411
Mailing address
11025 RCA CENTER DR, SUITE 300, PALM BEACH GARDENS, FL 33410-4269
(561) 514-5822
(561) 626-4530
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
1512LIC-14
NV
207ZD0900X
Dermatopathology (Pathology) Physician
1512LIC-14
NV
207ZH0000X
Hematology (Pathology) Physician
1512LIC-14
NV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1512LIC-14
NV
207ZP0213X
Pediatric Pathology Physician
1512LIC-14
NV
Other
Enumeration date
10/12/2016
Last updated
08/26/2022
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