# UNIVERSITY PEDIATRICIANS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033143904
- **Authorized official:** MARK HARRISON (COO)
- **Authorized official phone:** (313) 745-5870

## Contact information

- **Practice address:** 3901 BEAUBIEN, DETROIT, MI 48201
- **Practice address phone:** (313) 745-5214
- **Practice address fax:** (313) 745-5441
- **Mailing address:** 3901 BEAUBIEN ST STE H, DETROIT, MI 48201-2119
- **Mailing address phone:** (313) 745-5870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 10/28/2024