Provider Demographics
NPI:1669497517
Name:UROLOGY SPECIALISTS OF MICHIGAN, P.C.
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS OF MICHIGAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-551-9961
Mailing Address - Street 1:3535 W 13 MILE RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-551-2250
Mailing Address - Fax:248-551-2240
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:SUITE 501
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-2250
Practice Address - Fax:248-551-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty