# DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER

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

## Provider details

- **NPI number:** 1679808042
- **Authorized official:** GLORIA LARKINS (VICE PRESIDENT OF MICHIGAN)
- **Authorized official phone:** (313) 745-2117

## Contact information

- **Practice address:** 4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
- **Practice address phone:** (313) 745-4622
- **Mailing address:** PO BOX 67000 DEPT 614150, DETROIT, MI 48267-4150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2009
- **Last updated:** 10/02/2009