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General NPI Number Information
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NPI Number | 1235289356
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Entity Type | Organization
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Legal Business Name | CENTER UROLOGY ASSOCIATES
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4646 NANTUCKETT DR
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City | TOLEDO
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State | OH
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Zip | 43623-3194
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Country | US
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Telephone | 419-725-4400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 352408
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City | TOLEDO
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State | OH
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Zip | 43635-2408
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Country | US
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Telephone | 419-725-4400
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Fax | 419-535-7463
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. G MARK SEAL
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Credential | MD
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Telephone | 419-725-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | OH
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