Medical Diagnostic Lab, Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

475033 Issued in MI

Legal business name

MEDICAL DIAGNOSTIC LAB, INC

Practice address

1551 W Big Beaver Rd
D15
Troy, MI 48084-3528

Phone

(248) 659-8700

NPI assigned

Jan 23, 2007

Last updated

Dec 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter J Kalabat, M.D.NPI 1003900903

Title

Medical Director

Phone

(248) 649-8700

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Kalabat, MD

  • Specialist
  • Troy, MI
  • NPI 1003900903
  Authorized official Same address or phone

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1184778144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 W BIG BEAVER RD STE D15",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843528",
            "telephone_number": "248-659-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 W BIG BEAVER RD",
            "address_2": "D15",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843528",
            "telephone_number": "248-659-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC LAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "KALABAT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-649-8700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "475033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2726668",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Lee Medellin, M.D.
• Medex Home Health Care LLC
• Medexa, LLC
• Medi-Care
• Medical Center Pharmacy Inc. (Medical Center Pharmacy)
• Medical Service Company (Medical Service Companies)
• Medical Service Company (Medical Service Companies)
• Medstar Home Care, Inc. (Prescribed Health)
• Medsupply Corporation, Inc. (MedSupply Corp)
• Rachel Meerhaeghe, DPT

• Anatomic Pathology & Clinical Pathology Physician in Troy, MI
• Providers in Troy, 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 Dec 17, 2009; 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.