Provider Demographics
NPI:1245881374
Name:PREMIER UROLOGY PLLC
Entity type:Organization
Organization Name:PREMIER UROLOGY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALANEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-316-1967
Mailing Address - Street 1:7542 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1690
Mailing Address - Country:US
Mailing Address - Phone:313-316-1967
Mailing Address - Fax:
Practice Address - Street 1:19020 FORT ST
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-6701
Practice Address - Country:US
Practice Address - Phone:313-651-7053
Practice Address - Fax:313-488-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty