Individual
TAHER REZA KERMANSHAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
IHA PATHOLOGY & LABORATORY MANAGEMENT, 5301 E HURON RIVER DRIVE, YPSILANTI, MI 48197
(734) 712-3161
(734) 712-2244
Mailing address
24 FRANK LLOYD WRIGHT DRIVE, SUITE J2000, ANN ARBOR, MI 48105
(313) 593-7963
(313) 593-7143
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2011037784
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2014-01236
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301108473
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD36887
SC
Other
Enumeration date
07/16/2008
Last updated
03/30/2023
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