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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
208800000X
Urology Physician
Primary
2088P0231X
Pediatric Urology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
340H160300
BCBS
MI
Enumeration date
07/12/2006
Last updated
05/03/2021
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