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General NPI Number Information
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NPI Number | 1558370114
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Entity Type | Organization
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Legal Business Name | CASCADES UROLOGY P.C.
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2800 SPRING ARBOR RD
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City | JACKSON
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State | MI
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Zip | 49203-3608
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Country | US
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Telephone | 517-782-0200
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Fax | 517-784-1894
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Provider Business Mailing Address
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Address Line | 2800 SPRING ARBOR RD
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City | JACKSON
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State | MI
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Zip | 49203-3608
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Country | US
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Telephone | 517-782-0200
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Fax | 517-784-1894
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NITIN R AMBANI
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Credential | M.D.
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Telephone | 517-782-0200
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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 | NA049295
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License Number State | MI
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