Provider Demographics
NPI:1568570471
Name:FLINT CLINICAL PATHOLOGIST PC
Entity Type:Organization
Organization Name:FLINT CLINICAL PATHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-733-7741
Mailing Address - Street 1:9460 S SAGINAW RD STE D
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8207
Mailing Address - Country:US
Mailing Address - Phone:810-733-7741
Mailing Address - Fax:810-733-8898
Practice Address - Street 1:9460 S SAGINAW RD STE D
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8207
Practice Address - Country:US
Practice Address - Phone:810-733-7741
Practice Address - Fax:810-733-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1568570471Medicaid