Provider Demographics
NPI:1447276498
Name:REGIONAL PATHOLOGY CONSULTANTS, P.C.
Entity type:Organization
Organization Name:REGIONAL PATHOLOGY CONSULTANTS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEPOMPOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-969-6161
Mailing Address - Street 1:175 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-3432
Mailing Address - Country:US
Mailing Address - Phone:269-969-6161
Mailing Address - Fax:269-969-6078
Practice Address - Street 1:175 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-3432
Practice Address - Country:US
Practice Address - Phone:269-969-6161
Practice Address - Fax:269-969-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI220A360250OtherBCBSM
MIP78675OtherBLUE CARE NETWORK
MI1846053Medicaid
MI220A360180OtherBCBSM
MI220B376060OtherBCBSM
MI220A360250OtherBCBSM
MI0A36025Medicare ID - Type UnspecifiedMEDICARE
MI0B37606Medicare ID - Type UnspecifiedMEDICARE
MI220A360180OtherBCBSM