MEDICARE: UROLOGY HEALTH CENTER PLLC

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
1	208800000X	Urology Physician	4301059109	MI

General Provider Information

NPI Number	:	1821032798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY HEALTH CENTER PLLC

Provider Business Mailing Address
First Line	:	712 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-4211
Country	:	US
Telephone Number	:	989-893-4351
Fax Number	:	989-893-6412

Provider Business Practice Location Address
First Line	:	712 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-4211
Country	:	US
Telephone Number	:	989-893-4351
Fax Number	:	989-893-6412

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOUGLAS MAUPIN CUMMINGS
Credential	:	M.D.
Telephone Number	:	989-893-4351

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	10/20/2014

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