Northern Star Pathology, P.C.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

4301406387 Issued in MI

Legal business name

NORTHERN STAR PATHOLOGY, P.C.

Practice address

3401 Ludington St
Escanaba, MI 49829-1300

Phone

(906) 226-9127

NPI assigned

Feb 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cary Gottlieb, M.D.

Title

Owner

Phone

(906) 226-9127

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1063554129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300",
            "telephone_number": "906-226-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN STAR PATHOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-226-9127",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301406387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "220520070",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104194270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Karlie Jerise Ohman
• Ralph A Olechowski, D.O.

• Anatomic Pathology & Clinical Pathology Physician in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.