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
4201 SAINT ANTOINE ST, SUITE 5G, DETROIT, MI 48201-2153
(313) 745-4095
(313) 577-8555
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
1223P0700X
Prosthodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P32160
MEDICARE GROUP # - DDS
MI
Enumeration date
06/06/2006
Last updated
10/26/2016
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