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NPI Code Detail

MEDICARE: MICHIGAN INSTITUTE OF UROLOGY PC

MEDICARE: MICHIGAN INSTITUTE OF UROLOGY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CB9133OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2340E062730OTHERMIBCBSM

General Provider Information

NPI Number : 1730393927
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHIGAN INSTITUTE OF UROLOGY PC
Provider Business Mailing Address
First Line : 20952 12 MILE ROAD
Second Line : 200
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-3203
Country : US
Telephone Number : 586-771-4820
Fax Number : 586-771-9616
Provider Business Practice Location Address
First Line : 20952 12 MILE ROAD
Second Line : 200
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-3203
Country : US
Telephone Number : 586-771-4820
Fax Number : 586-771-9616
Authorized Official
Title or Position : PRESIDENT
Name : ALPHONSE SANTINO
Credential : MD
Telephone Number : 586-771-4820
Provider Enumeration Date : 05/09/2007
Last Update Date : 08/20/2024

Similar Medicare Providers

1427027416 — MICHIGAN INSTITUTE OF UROLOGY PC
Practice Location Address:
20952 12 MILE RD , SUITE 200
ST CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 586-771-7960
1346293412 — JOHN C PANOS MD
Practice Location Address:
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 586-771-6620
1245476670 — MICHIGAN INSTITUTE OF UROLOGY LABORATORY
Practice Location Address:
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 586-771-6620
1053674101 — DR. ROBERT LEWIS ELGIN D.O.
Practice Location Address:
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 586-771-6620
1033515036 — CARRIE L ANDERSON
Practice Location Address:
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 586-771-6620
1619331998 — DR. JACK TREBELHORN MD
Practice Location Address:
20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES, MI
48081-3203
Practice Phone: 586-771-4820
Practice Fax: 303-485-3377

Directions to “MICHIGAN INSTITUTE OF UROLOGY PC ” Practice Location

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