Organization
MICHIGAN INSTITUTE OF UROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LEE MCAULEY (CREDENTIALING SUPERVISOR)
(586) 771-4820
Entity
Organization
Contact information
Practice address
29275 NORTHWESTERN HWY STE 120, SOUTHFIELD, MI 48034-1044
(586) 771-4820
Mailing address
20952 E 12 MILE RD STE 200, SAINT CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-7960
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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