Organization
MICHIGAN UROLOGICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL MAATMAN (OFFICE MANAGER)
(616) 956-9577
Entity
Organization
Contact information
Practice address
4047 SALADIN DR SE, GRAND RAPIDS, MI 49546-6249
(616) 956-9577
(616) 956-3090
Mailing address
4047 SALADIN DR SE, GRAND RAPIDS, MI 49546-6249
(616) 956-9577
(616) 956-3090
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
696
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376586164
NPI
MI
Enumeration date
06/13/2006
Last updated
06/09/2008
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