UNIVERSITY PHYSICIAN GROUP


Address: 4201 Saint Antoine St., Suite 8d, Detroit, MI 48201
Phone: 3137454275

UNIVERSITY PHYSICIAN GROUP (NPI# 1457390254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457390254
Entity Type Organization
Organization Name UNIVERSITY PHYSICIAN GROUP
Practice Address 4201 Saint Antoine St.
Suite 8d
Detroit
MI 48201
Mailing Address 3800 Woodward Ave
Suite 600
Detroit
MI 48201-2061
Practice Telephone 3137454275
Enumeration Date 2006-06-06
Last Update Date 2007-12-12
Authorized Official Name MR. KENNETH P. LEE (CHIEF ADMINISTRATIVE OFFICER)
Authorized Official Telephone 3135778112
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist Behavioral Health & Social Service Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1336492354 University Physician Group Physical Therapist 44000 W 12 Mile Rd Ste 205, Wsupg Pm&r Oakwood, Novi, MI 48377-2647 2012-10-16
1447299797 University Physician Group Transplant Surgery 4201 St. Antoine St., Detroit, MI 48201 2006-06-05
1114384757 University Physician Group Eyewear Supplier (Equipment, not the service) 26400 W 12 Mile Rd, Suite 60, Southfield, MI 48034-1774 2016-01-27
1619380946 University Physician Group Pharmacist 1560 E Maple Rd, Suite 400, Troy, MI 48083-1138 2014-06-04
1215379938 University Physician Group Eyewear Supplier (Equipment, not the service) 1455 S Lapeer Rd, Suite 110, Lake Orion, MI 48360-1468 2013-07-23
1851630206 University Physician Group Occupational Therapist 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 2013-02-05
1992044598 University Physician Group Prosthetic/Orthotic Supplier 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 2013-02-04
1134492465 University Physician Group Eyewear Supplier (Equipment, not the service) 4700 Schaefer Rd, Suite 260, Dearborn, MI 48126-3698 2012-02-16
1336417146 University Physician Group Speech-Language Pathologist 4100 John R St, Karmanos Cancer Center-wertz Clinic, Detroit, MI 48201-2013 2011-12-07
1740590678 University Physician Group Eyewear Supplier (Equipment, not the service) 4700 Schaefer Rd, Suite 165, Dearborn, MI 48126-3698 2010-10-13

Office Location

Street Address 4201 SAINT ANTOINE ST.
SUITE 8D
City DETROIT
State MI
Zip Code 48201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417454356 David Chaar Student in an Organized Health Care Education/Training Program 4201 Saint Antoine St., University Health Center - 8d, Detroit, MI 48201 2018-04-08
1679513956 University Internal Medicine Specialists Internal Medicine 4201 Saint Antoine St., Suite 5c, Detroit, MI 48201 2006-06-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659989838 Saima Sharif Student in an Organized Health Care Education/Training Program 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 2020-07-14
1609494384 Praveen Kumar Boddu Student in an Organized Health Care Education/Training Program 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 2020-07-09
1730707720 Amr Hassan Abdelghaffar Omar Pediatrics 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 2020-07-07
1700400694 Hassan Imtiaz Student in an Organized Health Care Education/Training Program 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 2020-06-05
1598389074 Alaa Awad Elkarim Student in an Organized Health Care Education/Training Program 3901 Beaubien St. 3t72, Detroit, MI 48201 2020-06-01
1891319299 Jeongyeon Hwang Student in an Organized Health Care Education/Training Program 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 2020-06-01
1477176576 Jaudat Fatima Masood Student in an Organized Health Care Education/Training Program 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 2020-05-22
1205459419 Amit Kumar Dahiya Student in an Organized Health Care Education/Training Program 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 2020-05-21
1851914188 Asra Nausheen Shaik Student in an Organized Health Care Education/Training Program 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 2020-05-21
1568085751 Camille Olechowski Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 2020-05-21
Find all providers in zip 48201

Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588828453 Jin Lee Kim Clinical Neuropsychologist 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 2008-07-10
1841340312 Raymond Mckinley Campbell IIi Clinical Neuropsychologist 1511 1st St, Suite 1308, Detroit, MI 48226-1351 2007-01-10
1104939107 Jannel M Phillips Clinical Neuropsychologist 1 Ford Place, Detroit, MI 48202 2006-08-16
1952330474 Univeristy Affiliated Neurologists Clinical Neuropsychologist 4201 St. Antoine St, Suite 8d, Detroit, MI 48201 2006-06-30
1225038904 Scott Richard Millis Clinical Neuropsychologist 261 Mack Ave, Rehabilitation Institute of Michigan, Rm 552, Detroit, MI 48201-2417 2005-07-26
1285116384 Allison Josephine Lake Clinical Neuropsychologist 261 Mack Ave Ste 555, Detroit, MI 48201-2417 2018-09-05
1487193207 Vilija Petrauskas Clinical Neuropsychologist 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 2017-02-13
1053659482 Brent Funk Clinical Neuropsychologist 1 Ford Pl, 1e, Detroit, MI 48202-3450 2013-01-18
1215295191 Kathleen Margaret Hagelthorn Clinical Neuropsychologist 1 Ford Pl Ste 2e, Detroit, MI 48202-3450 2012-04-27
1063741270 Adult Neuropsychology Clinical Neuropsychologist 4201 Saint Antoine St, 4j Uhc, Detroit, MI 48201-2153 2009-12-17
Find all providers in DETROIT

Competitor

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City DETROIT
Zip Code 48201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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