Organization
UROLOGY ASSOC OF PORT HURON, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS J ADAIR (PRACTICE ADMINISTRATOR)
(810) 984-4194
Entity
Organization
Contact information
Practice address
1037 WATER ST, SUITE 1, PORT HURON, MI 48060-4408
(810) 984-4194
(810) 984-4674
Mailing address
1037 WATER ST, SUITE 1, PORT HURON, MI 48060-4408
(810) 984-4194
(810) 984-4674
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G41055
BLUE CROSS GROUP ID
MI
01
—
540G41006
BLUE CROSS
MI
Enumeration date
07/21/2006
Last updated
01/20/2010
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