# PATHOLOGY ASSOCIATES OF GRAND RAPIDS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184636821
- **Authorized official:** SARAT C KHANDAVALLI MD (PRESIDENT)
- **Authorized official phone:** (616) 252-7249

## Contact information

- **Practice address:** 200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503
- **Practice address phone:** (616) 364-6700
- **Practice address fax:** (616) 364-4960
- **Mailing address:** PO BOX 9186, LONGVIEW, TX 75608-9186
- **Mailing address phone:** (903) 663-4800
- **Mailing address fax:** (419) 223-2726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/12/2006
- **Last updated:** 04/15/2025