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Organization
WAYNE STATE UNIVERSITY
Active
Organization
WAYNE STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HORVAT (VP BUDGET AND DECISION SUPPORT)
(248) 581-5668
Entity
Organization
Contact information
Practice address
540 E CANFIELD ST STE 1241, DETROIT, MI 48201
(313) 577-1335
Mailing address
540 E CANFIELD ST STE 1241, DETROIT, MI 48201-1928
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
122300000X
Dentist
—
—
174400000X
Specialist
—
—
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
06/22/2018
Last updated
06/25/2018
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