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
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970H161220
BCBS
MI
Enumeration date
07/12/2006
Last updated
05/03/2021
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