Organization
DIAGNOSTIC LABORATORY SERVICES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD PETERS M.D. (AUTHORIZED OFFICIAL)
(231) 739-3911
Entity
Organization
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 739-3911
Mailing address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 739-3911
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029613
MIDWEST HEALTH PLAN
MI
01
—
0F16031
BLUE CROSS BLUE SHIELD
MI
01
—
1008785
KENT HEALTH PLAN
MI
01
—
107391
CARE CHOICES
MI
01
—
37137
COMMUNITY CHOICE MI
MI
01
—
970308
COMMUNITY CARE PLAN
MI
01
—
CK0248
RAILROAD MEDICARE
MI
01
—
XX09319
HEALTHPLUS
MI
Enumeration date
01/26/2007
Last updated
08/22/2020
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