Organization
KENT PATHOLOGISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WON KYU LEE MD (MEDICAL DIRECTOR MEMBER)
(616) 774-0209
Entity
Organization
Contact information
Practice address
200 JEFFERSON SE, ST MARYS HEALTH SERVICE PATHOLOGY DEPT, GRAND RAPIDS, MI 49503-4502
(616) 774-0209
Mailing address
2650 HORIZON DR SE, SUITE B, GRAND RAPIDS, MI 49546-7519
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
05/10/2006
Last updated
08/07/2007
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