Organization
UNIVERSITY PHYSICIAN GROUP
Active
Other names
Wayne State University Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY P KOHLITZ (CHIEF FINANCIAL OFFICER)
(248) 581-5930
Entity
Organization
Contact information
Practice address
4700 SCHAEFER RD, SUITE 260, DEARBORN, MI 48126-3698
(313) 945-8270
(313) 945-8731
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING DEPT., TROY, MI 48083-1138
(248) 581-5973
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4301054761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5717980005
NGS
MI
Enumeration date
02/16/2012
Last updated
12/01/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us