Promedica Genito-Urinary Surgeons LLC

NPI #1184051468 in Maumee, Ohio

Provider Information

NPI Number: 1184051468
Entity Type: Organization
Organization Name: Promedica Genito-Urinary Surgeons LLC
Primary Specialty: Urology
Enumeration Date: Oct 2, 2013
Last Updated: Oct 2, 2013

Practice Location

Address: 5757 MONCLOVA RD
Address 2: SUITE 6
City: Maumee
State: Ohio
ZIP Code: 43537-1863
Phone: (419) 897-7751

Authorized Official

Name: AMY L DWYER
Title: CREDENTIALING SUPERVISOR
Phone: (419) 824-7334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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