# MID-ATLANTIC PATHOLOGY SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MID-ATLANTIC PATHOLOGY SERVICES, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1194560953
- **Legal business name:** MID-ATLANTIC PATHOLOGY SERVICES, INC
- **Authorized official:** MICHAEL GRATTENDICK (CFO)
- **Authorized official phone:** (954) 803-9405

## Contact information

- **Practice address:** 1314 N MACOMB ST, MONROE, MI 48162-3131
- **Practice address phone:** (954) 803-9405
- **Mailing address:** 1355 RIVER BEND DR, DALLAS, TX 75247-4915
- **Mailing address phone:** (954) 803-9405

## 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:** 06/25/2024
- **Last updated:** 06/25/2024