Organization
MICHIGAN INSTITUTE OF UROLOGY LABORATORY
Active
Parent organization
MICHIGAN INSTITUTE OF UROLOGY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHIGAN INSTITUTE OF UROLOGY PC
Authorized official
BRIAN GUZ MD (PRESIDENT)
(586) 771-4820
Entity
Organization
Contact information
Practice address
20952 E 12 MILE RD STE 200, SAINT CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-6620
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
4301070286
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
690E02750
BCBSM
MI
Enumeration date
01/07/2009
Last updated
09/10/2019
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