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General NPI Number Information
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NPI Number | 1194288944
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Entity Type | Individual
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Provider Name | MARK PRESSPRICH
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Gender | Male
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 19117 ALLEN RD STE A
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City | BROWNSTOWN TWP
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State | MI
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Zip | 48183-1066
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Country | US
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Telephone | 734-676-4040
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Fax | 734-676-9897
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Provider Business Mailing Address
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Address Line | 20952 E 12 MILE RD STE 200
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-3203
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Country | US
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Telephone | 586-771-4820
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Fax | 586-771-7960
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301511048
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License Number State | MI
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