Provider Demographics
NPI:1801971197
Name:BIRMINGHAM UROLOGICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:BIRMINGHAM UROLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-642-4474
Mailing Address - Street 1:32000 EVERGREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2800
Mailing Address - Country:US
Mailing Address - Phone:248-642-4474
Mailing Address - Fax:248-642-4499
Practice Address - Street 1:1915 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7244
Practice Address - Country:US
Practice Address - Phone:248-642-4474
Practice Address - Fax:248-642-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
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