Organization
MICHIGAN DIAGNOSTIC PATHOLOGISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA EVANS MD (PRESIDENT)
(248) 849-3000
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, PROVIDENCE HOSPITAL, DEPARTMENT OF PATHOLOGY, SOUTHFIELD, MI 48075-4818
(248) 849-5401
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
Other
Enumeration date
03/20/2008
Last updated
02/19/2025
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