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 ST. ANTOINE, SUITE 4C, DETROIT, MI 48201
(313) 745-4525
Mailing address
3800 WOODWARD AVE., SUITE 600, DETRIOT, MI 48201
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H24886
BCBSM GROUP NUMBER
MI
Enumeration date
03/15/2007
Last updated
09/11/2025
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