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Organization
PATHOLOGY ASSOCIATES OF GRAND RAPIDS, P.C.
Active
Organization
PATHOLOGY ASSOCIATES OF GRAND RAPIDS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAT C KHANDAVALLI MD (PRESIDENT)
(616) 252-7249
Entity
Organization
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503
(616) 364-6700
(616) 364-4960
Mailing address
PO BOX 9186, LONGVIEW, TX 75608-9186
(903) 663-4800
(419) 223-2726
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
08/12/2006
Last updated
04/15/2025
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