# MICHIGAN UROLOGICAL INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558411512
- **Authorized official:** MRS. HILDA GIAMBINO (OFFICE MANAGER)
- **Authorized official phone:** (248) 569-0155

## Contact information

- **Practice address:** 22250 PROVIDENCE DR, SUITE 203, SOUTHFIELD, MI 48075-4825
- **Practice address phone:** (248) 569-0155
- **Practice address fax:** (248) 569-5226
- **Mailing address:** 22250 PROVIDENCE DR, SUITE 203, SOUTHFIELD, MI 48075-4825
- **Mailing address phone:** (248) 569-0155
- **Mailing address fax:** (248) 569-5226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | JO085172 | MI | — |
| 208800000X | Urology Physician | JS041027 | MI | — |
| 208800000X | Urology Physician | PH063189 | MI | — |
| 208800000X | Urology Physician | RW045789 | MI | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 01/20/2010