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General NPI Number Information
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NPI Number | 1114874633
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Entity Type | Organization
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Legal Business Name | MICHIGAN INSTITUTE OF UROLOGY PC
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 4047 E HILLS CT SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6249
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Country | US
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Telephone | 616-956-9577
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Fax | 616-956-5988
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Provider Business Mailing Address
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Address Line | 4047 E HILLS CT SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6249
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Country | US
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Telephone | 616-956-9577
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Fax | 616-956-5988
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Authorized Official
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Title or Position | CEO
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Name | THOMAS LANNI
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Credential |
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Telephone | 616-956-9577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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