Organization
NORTHWEST PATHOLOGY CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN EDELMAN (PRESIDENT)
(248) 858-3190
Entity
Organization
Contact information
Practice address
44405 WOODWARD AVENUE, ST JOSEPH MERCY HOSPITAL, PONTIAC, MI 48341-2985
(248) 858-3190
(248) 858-3148
Mailing address
PO BOX 670114, DETROIT, MI 48267-0114
(248) 858-3197
(248) 858-3148
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F36272
MEDICARE
MI
01
—
220F36272
BLUE CROSS BLUE SHEILD
MI
Enumeration date
05/22/2006
Last updated
06/14/2024
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