Organization
NORTHERN STAR PATHOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARY GOTTLIEB M.D. (OWNER)
(906) 226-9127
Entity
Organization
Contact information
Practice address
3401 LUDINGTON ST, ESCANABA, MI 49829-1300
(906) 226-9127
Mailing address
2837 US HIGHWAY 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
(906) 226-3875
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301406387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104194270
—
MI
01
—
220520070
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
02/13/2007
Last updated
03/11/2008
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