Organization · NPI-2

Alliance Physician Services Of Michigan, P.C.

Durable Medical Equipment & Medical Supplies · West Bloomfield, MI

NPI number1194807693

StatusActive

Last updated in NPPESSep 1, 2026

Details

NPI: 1194807693
Entity type: Organization (NPI-2)
Legal business name: Alliance Physician Services Of Michigan, P.C.
Organization subpart: Yes
Enumeration date: Oct 20, 2006
Certification date: Sep 1, 2026
Last updated: Sep 1, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
332B00000X	Durable Medical Equipment & Medical Supplies	–	–	Yes
208800000X	Urology	–	–
2088P0231X	Urology, Pediatric Urology	–	–
363L00000X	Nurse Practitioner	–	–

Other names

Michigan Institute Of Urology (Doing Business As)

Practice location

6900 Orchard Lake Road
Suite 101
West Bloomfield, MI 48322-3424

Phone 248-539-9036 · Fax 248-539-9267

Mailing address

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203

Phone 586-771-4820 · Fax 586-771-6620

Authorized official

Tracy Lee Mcauley
Credentialing Supervisor
5867714820

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