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Organization
UNIVERSITY PRIMARY CARE PRACTICES, INC.
Active
Organization
UNIVERSITY PRIMARY CARE PRACTICES, INC.
Active
Other names
UH State Road Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA M KENNEDY (DIRECTOR MED STAFF SERVICES & CRED)
(216) 844-2045
Entity
Organization
Contact information
Practice address
805 E WASHINGTON ST STE 100, MEDINA, OH 44256-3331
(330) 721-8474
(216) 201-8952
Mailing address
PO BOX 772040, DETROIT, MI 48277-2040
(216) 383-6480
(216) 383-6745
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
03/05/2007
Last updated
03/16/2021
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