Organization
MICHIGAN INSTITUTE OF UROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MCAULEY (CREDENTIALING SUPERVISOR)
(586) 771-4820
Entity
Organization
Contact information
Practice address
25 MICHIGAN ST NE, SUITE 3300, GRAND RAPIDS, MI 49503-2515
(616) 459-4171
(616) 459-0044
Mailing address
25 MICHIGAN ST NE STE 3300, GRAND RAPIDS, MI 49503-2558
(616) 459-4171
(616) 459-0044
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
MI
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
09/25/2006
Last updated
05/27/2025
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