# UNIVERSITY OTOLARYNGOLOGY

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

## Provider details

- **NPI number:** 1720103112
- **Authorized official:** SHARON BRANKA (COORDINATOR)
- **Authorized official phone:** (313) 745-1740

## Contact information

- **Practice address:** 43494 WOODWARD AVE, SUITE 210, BLOOMFIELD TOWNSHIP, MI 48302-5052
- **Practice address phone:** (248) 335-9800
- **Mailing address:** 3800 WOODWARD AVE, SUITE 600, DETROIT, MI 48201-2061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0H22557 | BCBSM GROUP NUMBER | MI |