Provider Demographics
NPI:1366442857
Name:MIAMI COUNTY UROLOGISTS INC
Entity type:Organization
Organization Name:MIAMI COUNTY UROLOGISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:BELAYET
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-335-0061
Mailing Address - Street 1:3130 N DIXIE HWY
Mailing Address - Street 2:STE. 205
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1337
Mailing Address - Country:US
Mailing Address - Phone:937-335-0061
Mailing Address - Fax:937-339-9336
Practice Address - Street 1:3130 N DIXIE HWY
Practice Address - Street 2:STE. 205
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1337
Practice Address - Country:US
Practice Address - Phone:937-335-0061
Practice Address - Fax:937-339-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058894208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0828000Medicaid
OHCA2248OtherRAILROAD MEDICARE
OH9178916Medicare ID - Type Unspecified
OHCA2248OtherRAILROAD MEDICARE