Organization
THE CENTERS FOR ADVANCED UROLOGY, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J HAGG (AUTHORIZED OFFICIAL)
(484) 530-0205
Entity
Organization
Contact information
Practice address
1 PRESIDENTIAL BLVD STE 100, BALA CYNWYD, PA 19004-1015
(610) 632-4100
(610) 668-1067
Mailing address
1 PRESIDENTIAL BLVD STE 100, BALA CYNWYD, PA 19004-1015
(610) 632-4100
(610) 668-1067
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
09/06/2017
Last updated
11/14/2025
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