Organization
GRAND HAVEN PATHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAY AARDEMA MD (PRESIDENT)
(616) 847-5200
Entity
Organization
Contact information
Practice address
1309 SHELDON RD, GRAND HAVEN, MI 49417-2404
(616) 847-5200
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38349342
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220G010300
BLUE CROSS
MI
Enumeration date
09/08/2005
Last updated
10/31/2013
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