# CENTRAL MICHIGAN UROLOGY CENTER PC

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

## Provider details

- **NPI number:** 1558420240
- **Authorized official:** DR. VIRINDER K BHARDWAJ MD (OWNER PRESIDENT)
- **Authorized official phone:** (989) 772-4051

## Contact information

- **Practice address:** 1111 S MISSION, STE 1, MOUNT PLEASANT, MI 48858
- **Practice address phone:** (989) 772-4051
- **Practice address fax:** (989) 773-3265
- **Mailing address:** 1111 S MISSION, STE 1, MOUNT PLEASANT, MI 48858
- **Mailing address phone:** (989) 772-4051
- **Mailing address fax:** (989) 773-3265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 430104U214 | MI | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 07/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 340C710990 | BCBS | MI |
| 05 | — | 4700571 | — | MI |