NORTHERN STAR PATHOLOGY, P.C. (NPI# 1063554129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063554129 |
| Entity Type | Organization |
| Organization Name | NORTHERN STAR PATHOLOGY, P.C. |
| Practice Address |
3401 Ludington St Escanaba MI 49829-1300 |
| Mailing Address |
2837 Us Highway 41 W Marquette MI 49855-2252 |
| Practice Telephone | 9062269127 |
| Mailing Telephone | 9062253964 |
| Mailing Fax Number | 9062263875 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2008-03-11 |
| Authorized Official Name | CARY GOTTLIEB (OWNER) |
| Authorized Official Telephone | 9062269127 |
| 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 |
4301406387 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD MI | 220520070 | 01 |
| MI | 104194270 | 05 |
| Street Address |
3401 LUDINGTON ST |
| City | ESCANABA |
| State | MI |
| Zip Code | 49829-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467447813 | Kaladevi Nadarajan | Internal Medicine | 3401 Ludington St, Escanaba, MI 49829-1300 | 2005-09-13 |
| 1679113385 | Stacey Lynn Stier | Nurse Practitioner | 3401 Ludington St, Escanaba, MI 49829-1300 | 2020-01-10 |
| 1972141513 | Cira Michigan, P.C. | Radiology | 3401 Ludington St, Escanaba, MI 49829-1300 | 2019-12-13 |
| 1619511037 | Shania Jean Tebo | Dietitian, Registered | 3401 Ludington St, Escanaba, MI 49829-1300 | 2019-10-29 |
| 1366906786 | Laura Kae Mead | Speech-Language Pathologist | 3401 Ludington St, Escanaba, MI 49829-1300 | 2019-01-30 |
| 1922582881 | Andrew James Gearhart | Nurse Practitioner | 3401 Ludington St, Escanaba, MI 49829-1300 | 2018-09-18 |
| 1790287456 | Shayne R Lamarch | Dietitian, Registered | 3401 Ludington St, Escanaba, MI 49829-1300 | 2018-03-08 |
| 1669997292 | Julie Aschbacher | Speech-Language Pathologist | 3401 Ludington St, Escanaba, MI 49829-1300 | 2017-08-04 |
| 1528508587 | Linda Klope | Dietitian, Registered | 3401 Ludington St, Escanaba, MI 49829-1300 | 2017-02-24 |
| 1922545250 | Gregory Mishica | Physical Therapist | 3401 Ludington St, Escanaba, MI 49829-1300 | 2017-01-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770192510 | Haas Hearing Pllc | Audiologist | 423 Ludington Street, Escanaba, MI 49829 | 2020-07-28 |
| 1104308535 | Lindsay Hope Hall | Occupational Therapist | 2415 5th Ave, Escanaba, MI 49829 | 2018-09-01 |
| 1962941260 | Amber Joy Quigley | Speech-Language Pathologist | 300 Willow Creek Road, Escanaba, MI 49829 | 2017-02-20 |
| 1316377799 | Michelle M Holochwost | Physical Therapist | 501 S. Lincoln Road, Escanaba, MI 49829 | 2013-11-20 |
| 1518304179 | Megan Haas | Audiologist | 423, Suite 1, Escanaba, MI 49829 | 2013-05-22 |
| 1063768422 | Stacey Lynn Cole | Nurse Practitioner | 3409 Ludington St Ste 104, Escanaba, MI 49829 | 2012-08-03 |
| 1407177678 | Sarah Jean Nault | Physical Therapist | 501 S. Lincoln Rd, Escanaba, MI 49829 | 2010-06-22 |
| 1851572960 | James Brian Hull | Occupational Therapist | 2415 Fifth Avenue South, Escanaba, MI 49829 | 2007-11-16 |
| 1497942841 | Anne M Stein | Nurse Practitioner | 7100 Co. Rd. 426, Escanaba, MI 49829 | 2007-10-01 |
| 1083813703 | Michael Czerkes | Obstetrics & Gynecology | 3409 Ludington St Ste 204, Escanaba, MI 49829 | 2007-07-12 |
| Find all providers in zip 49829 | ||||
| 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 |
|---|---|---|---|---|
| 1598036196 | St Francis Hospital | Pathology | 3401 Ludington St, Escanaba, MI 49829-1300 | 2012-01-13 |
| 1932206455 | St Francis Hospital | Pathology | 3401 Ludington St, Escanaba, MI 49829-1300 | 2006-09-19 |
| 1649242124 | Cary A Gottlieb | Pathology | 3401 Ludington St, Escanaba, MI 49829-1300 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1942756234 | Ahmed Alrajjal | Pathology | 459 Calvin Avenue, Grosse Pointe Farms, MI 48236-3236 | 2016-08-28 |
| 1649630435 | Barry Dewitt | Pathology | 11345 Greenview Dr, Fenton, MI 48430-2591 | 2016-03-07 |
| 1922467919 | Wilford E. Maldonado | Pathology | 4722 Huron Hill Dr, Okemos, MI 48864-2052 | 2016-02-18 |
| 1144636895 | Ramya Gadde | Pathology | 2799 W.grand Boulevard,henry Ford Hospital, Detroit, MI 48202-2608 | 2014-07-02 |
| 1710329206 | Yulei Shen | Pathology | 1546 Brentwood Dr, Troy, MI 48098-2713 | 2013-07-24 |
| 1437596046 | John P Sherbeck | Pathology | 5305 East Huron River Drive, Ann Arbor, MI 48106 | 2013-05-23 |
| 1942552336 | Kusum Kumar | Pathology | 3885 Highwood Pl, Okemos, MI 48864-3790 | 2012-10-09 |
| 1073864898 | Karel Kithier | Pathology | 5022 Temple Drive, Sterling Heights, MI 48310-4067 | 2012-09-20 |
| 1306191085 | Nathan Stepanek Shaller | Pathology | 1301 Catherine Street, Ann Arbor, MI 48109-5602 | 2012-07-18 |
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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.