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Organization
MINIMALLY INVASIVE AND ROBOTIC UROLOGY OBS LLC
Active
Organization
MINIMALLY INVASIVE AND ROBOTIC UROLOGY OBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GANESH SIVARAJAN MD (MEDICAL DIRECTOR)
(630) 567-3238
Entity
Organization
Contact information
Practice address
20325 N 51ST AVE STE 102, GLENDALE, AZ 85308-5665
(630) 567-3238
Mailing address
22230 N 55TH ST, PHOENIX, AZ 85054-7157
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/20/2023
Last updated
07/15/2024
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