Provider Demographics
NPI:1972930055
Name:MIRELMAN UROLOGY, PC
Entity type:Organization
Organization Name:MIRELMAN UROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-877-2767
Mailing Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR STE 313
Mailing Address - Street 2:ATTN: BRIAN LASKER
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6807
Mailing Address - Country:US
Mailing Address - Phone:205-877-2767
Mailing Address - Fax:866-591-9511
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:STE 305
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-877-2767
Practice Address - Fax:866-591-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty