Provider Demographics
NPI:1508834755
Name:MIDWEST PROSTATE & UROLOGICAL INSTITUTE
Entity Type:Organization
Organization Name:MIDWEST PROSTATE & UROLOGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MPUI
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:OESTERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-799-4840
Mailing Address - Street 1:1740 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638
Mailing Address - Country:US
Mailing Address - Phone:989-799-4840
Mailing Address - Fax:989-799-4994
Practice Address - Street 1:1740 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638
Practice Address - Country:US
Practice Address - Phone:989-799-4840
Practice Address - Fax:989-799-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3439412Medicaid
MIB70635Medicare UPIN
MI3439412Medicaid