| NPI | 1467603746 |
|---|---|
| Doing Business As | EDISON LAKES UROLOGY - MICHIGAN OFFICE |
| Entity Type | Organization |
| Authorized Contact | DARRYL R. BUSBY Executive Administrator 574-296-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |