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Organization

UNIVERSITY INTERNAL MEDICINE SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JILL G. MOORE (ADMINISTRATOR)
(313) 745-8212
Entity
Organization

Contact information

Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 745-4525
Mailing address
3800 WOODWARD AVE, SUITE 600, DETROIT, MI 48201-2061

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
207RH0003X
Hematology & Oncology Physician
207RX0202X
Medical Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0H24795
BCBSM GROUP NUMBER
MI
Enumeration date
03/15/2007
Last updated
09/11/2025
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