Provider Demographics
NPI:1043527005
Name:OKEMOS UROLOGY CONSULTANTS PLC
Entity Type:Organization
Organization Name:OKEMOS UROLOGY CONSULTANTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIRINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-393-9300
Mailing Address - Street 1:2400 SCIENCE PKWY
Mailing Address - Street 2:202
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-5506
Mailing Address - Country:US
Mailing Address - Phone:517-393-9300
Mailing Address - Fax:517-393-3003
Practice Address - Street 1:2400 SCIENCE PKWY
Practice Address - Street 2:202
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-5506
Practice Address - Country:US
Practice Address - Phone:517-393-9300
Practice Address - Fax:517-393-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030430208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty