EARL R KOENIG (NPI# 1083679070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083679070 |
| Entity Type | Individual |
| Full Name | EARL R KOENIG |
| Credential | MD |
| Practice Address |
11051 Hall Rd Suite 200 Utica MI 48317-5735 |
| Mailing Address |
20952 E 12 Mile Rd Suite 200 St Clair Shores MI 48081-3200 |
| Practice Telephone | 5862545759 |
| Practice Fax Number | 5862545793 |
| Mailing Telephone | 5867714820 |
| Mailing Fax Number | 5867716620 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2008-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 4301030802 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | HAP | B45210 | 01 |
| MI | RAILROAD MEDICARE | 340019484 | 01 |
| MI | AETNA | 4391724 | 01 |
| MI | CIGNA | 5259095001 | 01 |
| MI | PRIORITY HEALTH | 102426 | 01 |
| Street Address |
11051 HALL RD SUITE 200 |
| City | UTICA |
| State | MI |
| Zip Code | 48317-5735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407846462 | Deborah L Mikula | Obstetrics & Gynecology | 11051 Hall Rd, Suite 110, Utica, MI 48317-5735 | 2005-10-21 |
| 1366895559 | Michigan Neurology Associates Dme | Durable Medical Equipment & Medical Supplies | 11051 Hall Rd, Ste 240, Utica, MI 48317-5735 | 2016-07-22 |
| 1770818528 | Dawn Marie Roxborough | Nurse Practitioner | 11051 Hall Rd, Suite 120, Utica, MI 48317-5735 | 2009-10-13 |
| 1316116726 | Hematology-oncology Assoc. East, PC | Internal Medicine | 11051 Hall Rd, Suite 120, Utica, MI 48317-5735 | 2008-02-29 |
| 1760664023 | Ann Arbor Anesthesia Associates Inc | Nurse Anesthetist, Certified Registered | 11051 Hall Rd, Suite 230, Utica, MI 48317-5735 | 2007-11-28 |
| 1841495132 | Utica Asc Partners, LLC | Clinic/Center | 11051 Hall Rd, Suite 230, Utica, MI 48317-5735 | 2007-06-18 |
| 1881769545 | Clinton Women's Healthcare, PC | Obstetrics & Gynecology | 11051 Hall Rd, Suite 110, Utica, MI 48317-5735 | 2006-11-21 |
| 1649351560 | Cammy E Beglin | Obstetrics & Gynecology | 11051 Hall Rd, Suite 110, Utica, MI 48317-5735 | 2006-10-18 |
| 1326138033 | Michigan Institute of Urology PC | Urology | 11051 Hall Rd, Suite 200, Utica, MI 48317-5735 | 2006-10-13 |
| 1427155357 | Great Lakes Cancer Mgmt Specialists | Non-Pharmacy Dispensing Site | 11051 Hall Rd, Ste 120, Utica, MI 48317-5735 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329686 | Jasmine Withers | Driver | 45835 Brownell St, Apt 9, Utica, MI 48317 | 2020-03-02 |
| 1942851670 | Kn Mental Health Services LLC | Social Worker | 1111 Hall Road, Utica, MI 48317 | 2019-09-24 |
| 1710461421 | Pureland Physical Therapy | Physical Medicine & Rehabilitation | 45555 Mound Rd, Shelby Twp, MI 48317 | 2018-09-18 |
| 1417433566 | Stephanie Marie Renner | Occupational Therapist | Regency At Shelby, 7401 22 Mile Road, Shelby Charter Township, MI 48317 | 2018-07-12 |
| 1437645959 | Jonathan G Deck | Physician Assistant | 46961 Vandyke Ave, Sheby Township, MI 48317 | 2018-07-09 |
| 1013407261 | Meredith Ann Schramski | Physician Assistant | 46961 Van Dyke Ave, Shelby Township, MI 48317 | 2018-05-14 |
| 1114446184 | Patrick Michael Roberts | Physician Assistant | 50149 Hedgeway Dr, Shelby Twp, MI 48317 | 2017-09-11 |
| 1427571702 | Boby Philip Manalel | Physical Therapist | 11150 Nature Way, Shelby Twp, MI 48317 | 2017-07-19 |
| 1285155119 | Shelby Urgent Care Walk-in Clinic | Family Medicine | 46965 Van Dyke Ave, Shelby Twp, MI 48317 | 2017-06-30 |
| 1942650718 | Samantha Parison | Technician, Other | 47980 Shelby Road, Shelby Township, MI 48317 | 2016-06-13 |
| Find all providers in zip 48317 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917243 | Hanan Goldberg | Urology | 1676 Sunset Ave Fl 2, Utica, NY 13502-5416 | 2019-11-19 |
| 1518918002 | Stephen John Culver | Urology | 2811 Genesee St, Utica, NY 13501-6525 | 2006-05-12 |
| 1073690830 | Utica Urologic Associates, P.C. | Urology | 3 Parkside Ct, Utica, NY 13501-5643 | 2006-11-01 |
| 1326138033 | Michigan Institute of Urology PC | Urology | 11051 Hall Rd, Suite 200, Utica, MI 48317-5735 | 2006-10-13 |
| 1043275019 | John R Harding | Urology | 11051 Hall Rd, Suite 200, Utica, MI 48317-5735 | 2006-04-20 |
| 1669473583 | Mohawk Valley Urology PC | Urology | 1703 Genesee St, Utica, NY 13501-5613 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1770072498 | Bellin Health Iron Mountain Inc | Urology | 1005 S Hemlock St Ste B, Iron Mountain, MI 49801-3854 | 2018-05-08 |
| 1205215621 | Alexander David Tapper | Urology | 44200 Woodward Ave Ste 207, Pontiac, MI 48341-5045 | 2015-05-19 |
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1609213636 | Arya Khatiwoda | Urology | 2900 Hannah Blvd Ste 104, East Lansing, MI 48823-5380 | 2013-05-31 |
| 1003179730 | Kalen Jacob Rimar | Urology | 130 Town Center Dr Ste 101, Troy, MI 48084 | 2012-06-18 |
| 1780955294 | Harry Nicholas Kotsis | Urology | 265 Touraine Rd, Grosse Pointe Farms, MI 48236-3308 | 2012-01-16 |
| 1750678264 | Michael Kozminski | Urology | 245 Cherry St Se Ste 202, Grand Rapids, MI 49503-4607 | 2011-07-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EARL R KOENIG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.