Basic Information
| Provider Information | |||||||||
| NPI: | 1972930055 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIRELMAN UROLOGY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2022 BROOKWOOD MEDICAL CTR DR STE 313 | ||||||||
| Address2: | ATTN: BRIAN LASKER | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058772767 | ||||||||
| FaxNumber: | 8665919511 | ||||||||
| Practice Location | |||||||||
| Address1: | 2018 BROOKWOOD MEDICAL CTR DR | ||||||||
| Address2: | STE 305 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058772767 | ||||||||
| FaxNumber: | 8665919511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 10/03/2013 | ||||||||
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| AuthorizedOfficialLastName: | LASKER | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2058772767 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.