Organization
REGENTS OF THE UNIVERSITY OF MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHRISTOPHER MILLER (PRESIDENT)
(734) 936-3568
Entity
Organization
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, PROVIDER ENROLLMENT, ANN ARBOR, MI 48108
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350H111920
BCBS
MI
Enumeration date
07/08/2006
Last updated
05/03/2021
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