MEDICAL DIAGNOSTIC LAB, INC (NPI# 1184778144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184778144 |
| Entity Type | Organization |
| Organization Name | MEDICAL DIAGNOSTIC LAB, INC |
| Practice Address |
1551 W Big Beaver Rd D15 Troy MI 48084-3528 |
| Mailing Address |
1551 W Big Beaver Rd Ste D15 Troy MI 48084-3528 |
| Practice Telephone | 2486598700 |
| Mailing Telephone | 2486598700 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2009-12-17 |
| Authorized Official Name | PETER J KALABAT (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2486498700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
475033 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2726668 | 05 |
| Street Address |
1551 W BIG BEAVER RD D15 |
| City | TROY |
| State | MI |
| Zip Code | 48084-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740294768 | Joseph William Robertson | Dentist | 1551 W Big Beaver Rd, Ste D-14, Troy, MI 48084-3528 | 2006-07-27 |
| 1003900903 | Peter Kalabat | Specialist | 1551 W Big Beaver Rd, Ste D15, Troy, MI 48084-3528 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360242 | Keely Erin Zuri | Physical Therapy Assistant | 3250 W. Big Beaver, Troy, MI 48084 | 2020-09-09 |
| 1841762473 | Hunter Thomas Michaels | Kinesiotherapist | 3250 West Big Beaver Rd, Suite 228, Troy, MI 48084 | 2018-12-20 |
| 1265900864 | Michelle Denise Carter | Massage Therapist | 3250 West Big Beaver Suite 228, Troy, MI 48084 | 2018-11-13 |
| 1770083925 | Troy Daniel Burrell | Clinical Exercise Physiologist | 3250 West Big Beaver Rd, Suite 228, Troy, MI 48084 | 2018-02-14 |
| 1174030175 | Alexander Scott | Kinesiotherapist | 3250 W. Big Beaver Rd., Troy, MI 48084 | 2017-12-29 |
| 1568977213 | Mallory Rose Valeri | Specialist/Technologist | 3250 W. Big Beaver Rd, Suite 228, Troy, MI 48084 | 2017-12-04 |
| 1710409651 | Eduardo Martin Pinto | Pharmacist | 3811 Coolidge Hwy, Troy, MI 48084 | 2017-07-12 |
| 1659891653 | Tricia Michelle Forgash | Recreation Therapist | 1998 Dorchester Dr. N 106, Troy, MI 48084 | 2017-06-21 |
| 1851759278 | Lauren Field | Counselor | 3290 W Big Beaver Rd Ste 188, Troy, MI 48084 | 2016-01-30 |
| 1265806939 | Tammy Scott-barney | Nurse Practitioner | 888 W Big Beaver Rd Ste 900, Troy, MI 48084 | 2015-11-18 |
| Find all providers in zip 48084 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710329206 | Yulei Shen | Pathology | 1546 Brentwood Dr, Troy, MI 48098-2713 | 2013-07-24 |
| 1649408451 | Charles Eugene Smart | Pathology | 2811 Charter Dr, #206, Troy, MI 48083-1323 | 2009-06-30 |
| 1417128117 | Thomas Owen Robbins | Pathology | 2540 Timberwyck Trail Dr, Troy, MI 48098-4104 | 2008-03-20 |
| 1811934300 | Mingxin Che | Pathology | 264 W Maple Road, Suite 200, Troy, MI 48084 | 2006-06-01 |
| 1598194821 | Upstate Empire Pathology Pllc | Pathology | 2215 Burdett Ave, Troy, NY 12180-2466 | 2013-11-07 |
| 1518242122 | R&c Pathology Consultants Inc | Pathology | 3130 N Dixie Hwy, Troy, OH 45373-1337 | 2011-10-14 |
| 1720306152 | Guilian Niu | Pathology | 2215 Burdett Ave, Troy, NY 12180-2466 | 2010-05-10 |
| 1174752463 | Kinda Hayek | Pathology | 500 Kirts Blvd, Troy, MI 48084-4134 | 2009-07-07 |
| 1700053873 | Nancy Corpuz | Pathology | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2008-05-08 |
| 1376716894 | Imrana Ali | Pathology | 1300 Massachusetts Ave, Troy, NY 12180-1628 | 2008-04-04 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.