# MICHIGAN DIAGNOSTIC PATHOLOGISTS, PLLC

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

## Provider details

- **NPI number:** 1578734281
- **Authorized official:** JUANITA EVANS MD (PRESIDENT)
- **Authorized official phone:** (248) 849-3000

## Contact information

- **Practice address:** 16001 W 9 MILE RD, PROVIDENCE HOSPITAL, DEPARTMENT OF PATHOLOGY, SOUTHFIELD, MI 48075-4818
- **Practice address phone:** (248) 849-5401
- **Mailing address:** 5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZB0001X | Blood Banking & Transfusion Medicine Physician | — | NULL | — |
| 207ZB0001X | Blood Banking & Transfusion Medicine Physician | — | — | — |
| 207ZC0500X | Cytopathology Physician | — | NULL | — |
| 207ZC0500X | Cytopathology Physician | — | — | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | NULL | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | — | — |
| 207ZH0000X | Hematology (Pathology) Physician | — | NULL | — |
| 207ZH0000X | Hematology (Pathology) Physician | — | — | — |
| 207ZI0100X | Immunopathology Physician | — | NULL | — |
| 207ZI0100X | Immunopathology Physician | — | — | — |
| 207ZM0300X | Medical Microbiology Physician | — | NULL | — |
| 207ZM0300X | Medical Microbiology Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | NULL | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 03/20/2008
- **Last updated:** 02/19/2025