Provider Demographics
NPI:1336201110
Name:METROPOLITAN UROLOGY GROUP, SC
Entity Type:Organization
Organization Name:METROPOLITAN UROLOGY GROUP, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-732-2715
Mailing Address - Street 1:2600 N MAYFAIR RD
Mailing Address - Street 2:SUITE 580
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1309
Mailing Address - Country:US
Mailing Address - Phone:414-732-2715
Mailing Address - Fax:414-476-3242
Practice Address - Street 1:2600 N MAYFAIR RD
Practice Address - Street 2:SUITE 580
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1309
Practice Address - Country:US
Practice Address - Phone:414-732-2715
Practice Address - Fax:414-476-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI68640Medicare ID - Type UnspecifiedWAUKESHA CTY GROUP NUMBER
WI02050Medicare ID - Type UnspecifiedMILW CTY GROUP NUMBER
0384200001Medicare NSC