Organization
MICHIGAN INSTITUTE OF UROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN V GUZ MD (PRESIDENT)
(586) 771-4820
Entity
Organization
Contact information
Practice address
20952 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-7960
Mailing address
20952 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-7960
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
—
—
2085R0001X
Radiation Oncology Physician
4301046765
MI
2085R0202X
Diagnostic Radiology Physician
4301038127
MI
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BCBSM
MI
01
—
340E062730
BCBSM
MI
01
—
CB9133
RAILROAD MEDICARE
MI
Enumeration date
03/14/2006
Last updated
03/25/2025
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