Provider Demographics
NPI:1528023892
Name:GEORGE, VALAL K (MD)
Entity Type:Individual
Prefix:
First Name:VALAL
Middle Name:K
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20952 E 12 MILE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3200
Mailing Address - Country:US
Mailing Address - Phone:586-771-4820
Mailing Address - Fax:586-771-6620
Practice Address - Street 1:20952 E 12 MILE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3200
Practice Address - Country:US
Practice Address - Phone:586-771-4820
Practice Address - Fax:586-771-6620
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2008-07-28
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Provider Licenses
StateLicense IDTaxonomies
MI4301066284208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7822183OtherCIGNA
MIH39856OtherHAP
MI132838OtherPRIORITY HEALTH
MIP00061107OtherRAILROAD MEDICARE
MI7847331OtherAETNA
MI132838OtherPRIORITY HEALTH
MI7847331OtherAETNA
MIH39856OtherHAP