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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
1000 WALL STREET, ANN ARBOR, MI 48105-0714
(734) 763-1415
Mailing address
3621 S STATE ST, PROVIDER ENROLLMENT, ANN ARBOR, MI 48108
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
207WX0107X
Retina Specialist (Ophthalmology) Physician
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
207WX0109X
Neuro-ophthalmology Physician
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
207WX0120X
Cornea and External Diseases Specialist Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180H113180
BCBS
MI
01
180H160980
BCBS
MI
Enumeration date
07/08/2006
Last updated
04/30/2021
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