Organization
UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL G. MOORE (ADMINISTRATOR)
(313) 745-8212
Entity
Organization
Contact information
Practice address
4201 SAINT ANTOINE ST., SUITE 5C, DETROIT, MI 48201
(313) 745-4525
Mailing address
3800 WOODWARD AVE, SUITE 600, DETROIT, MI 48201-2061
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H24802
BCBSM GROUP #
MI
Enumeration date
06/07/2006
Last updated
09/11/2025
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