Organization
MICHIGAN INSTITUTE OF UROLOGY PC
Active
Other names
Urological Services PC
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LEE MCAULEY (CREDENTIALING SPECIALIST)
(586) 771-4820
Entity
Organization
Contact information
Practice address
1121 W HILL RD, FLINT, MI 48507-4733
(810) 232-8888
(810) 232-9190
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
208800000X
Urology Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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