Organization
UROLOGICAL CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. MICHAEL PEREZ M.D. (PRESIDENT)
(765) 962-8551
Entity
Organization
Contact information
Practice address
1485 CHESTER BLVD, RICHMOND, IN 47374-1919
(765) 962-8551
(765) 966-8089
Mailing address
1485 CHESTER BLVD, RICHMOND, IN 47374-1919
(765) 962-8551
(765) 966-8089
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
50002706A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0136730
OH MEDICAID GROUP #
OH
01
—
CM9450
TRAVELERS MEDICARE GROUP#
IN
Enumeration date
07/22/2006
Last updated
08/22/2020
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