Organization
INSTITUTE FOR POPULATION HEALTH INC.
Active
Organization
INSTITUTE FOR POPULATION HEALTH INC.
Active
Other names
School Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WILLIAMSON (REVENUE MANAGER)
(313) 309-9350
Entity
Organization
Contact information
Practice address
15491 MADDELEIN ST, DETROIT, MI 48205-2596
(313) 309-9350
(313) 309-5060
Mailing address
15491 MADDELEIN ST, DETROIT, MI 48205-2596
(313) 309-9350
(313) 309-5060
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231117
—
MI
01
—
71020000H28082
BLUE CROSS
MI
Enumeration date
03/07/2019
Last updated
12/12/2023
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