NPI 1063708592

Bear River Urology, LLC

Organisation Urology Physician Evanston, WY

Practice location

Address: 196 Arrowhead Dr Suite #4, Evanston, WY 82930-8752
Phone: (307) 789-8721

Authorised official

Name: Michael E van Bibber
Title: Owner
Phone: (801) 821-6717

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence TL#1572 (WY)

Other Urology providers in Wyoming →

Registry record

NPI: 1063708592
Entity type: Organization
NPI issued: 23 Jun 2011
Record last updated: 23 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.