Organization
CENTER UROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. G MARK SEAL MD (PRESIDENT)
(419) 725-4400
Entity
Organization
Contact information
Practice address
4646 NANTUCKETT DR, TOLEDO, OH 43623-3194
(419) 725-4400
Mailing address
PO BOX 352408, TOLEDO, OH 43635-2408
(419) 725-4400
(419) 535-7463
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000133106
ANTHEM
OH
01
—
00548
PARAMOUNT
OH
05
—
0594129
—
OH
01
—
306582913012
MEDICAL MUTUAL OF OH
OH
01
—
4032363
AETNA
OH
Enumeration date
01/11/2007
Last updated
08/22/2020
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