UNIVERSITY PHYSICIAN GROUP (NPI# 1538374756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538374756 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PHYSICIAN GROUP |
| Other Organization Name | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Practice Address |
3901 Chrysler Dr Tolan Park Detroit MI 48201-2167 |
| Mailing Address |
1560 E Maple Rd Suite 400-credentialing Dept. Troy MI 48083-1138 |
| Practice Telephone | 3139933434 |
| Practice Fax Number | 3139933421 |
| Mailing Telephone | 2485815973 |
| Mailing Fax Number | 2485815640 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | MR. JEFFERY P KOHLITZ (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2485815930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP NUMBER | 0H22874 | 01 |
| MI | BCBSM GROUP NUMBER | 0H22830 | 01 |
| MI | BCBSM GROUP NUMBER | 0H22832 | 01 |
| MI | BCBSM GROUP NUMBER | 0H22872 | 01 |
| Other Name | Type Code |
|---|---|
| Wayne State University Physician Group | Doing Business As Name - Organization |
| 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 |
| 1457390254 | University Physician Group | Clinical Neuropsychologist | 4201 Saint Antoine St., Suite 8d, Detroit, MI 48201 | 2006-06-06 |
| 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 |
| Street Address |
3901 CHRYSLER DR TOLAN PARK |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306844998 | Belverly J Jones | Nurse Practitioner | 3901 Chrysler Dr, Ste 4a, Detroit, MI 48201-2167 | 2005-07-08 |
| 1679193585 | Sarah Beth Murray | Social Worker | 3901 Chrysler Dr, Detroit, MI 48201-2167 | 2020-04-21 |
| 1265095681 | Samuel Joseph Malian | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr, Detroit, MI 48201-2167 | 2019-04-22 |
| 1710348859 | Ashley Burgess | Registered Nurse | 3901 Chrysler Dr, Detroit, MI 48201-2167 | 2016-03-17 |
| 1629437769 | Mia Michelle Hall | Social Worker | 3901 Chrysler Dr, Detroit, MI 48201-2167 | 2016-02-17 |
| 1639550346 | Joseph Darwiyn Enos | Nurse Practitioner | 3901 Chrysler Dr, Ste 4a, Detroit, MI 48201-2167 | 2015-06-18 |
| 1376948919 | Shatha Alkatib | Physician Assistant | 3901 Chrysler Dr, Detroit, MI 48201-2167 | 2014-10-24 |
| 1629400270 | Marquetta Yolanda Norwood | Nurse Practitioner | 3901 Chrysler Dr, Ste 4a, Detroit, MI 48201-2167 | 2013-08-06 |
| 1073952842 | Kelly Marie Powell | Social Worker | 3901 Chrysler Dr, Detroit, MI 48201 | 2013-06-14 |
| 1487907556 | Sarah Saunders | Social Worker | 3901 Chrysler Dr, 4a, Detroit, MI 48201-2167 | 2012-10-25 |
| Find all providers in the same location | ||||
| 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 Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143046 | Comforting Adult Services LLC | Counselor | 14559 Monica St, Detroit, MI 48238-1953 | 2020-01-18 |
| 1235779406 | Jacqueline Yvetter Smith Davis | Counselor | 16609 Archdale St, Detroit, MI 48235-3416 | 2020-01-15 |
| 1033767843 | Shawn Alecia Mccoy | Counselor | 3600 3rd St Apt 1004, Detroit, MI 48201-2337 | 2019-08-27 |
| 1013472745 | Shyfirska Emery | Counselor | 13700 Linnhurst St, Detroit, MI 48205-2885 | 2019-02-06 |
| 1871060368 | Taia Sardinas | Counselor | 7251 E Congress St Apt 307, Detroit, MI 48214-2395 | 2018-11-01 |
| 1639668387 | Debora Lynn Howard | Counselor | 17200 Rowe St, Detroit, MI 48205-3120 | 2018-05-08 |
| 1932698669 | Alexis J Terry | Counselor | 5555 Conner St Ste 2210, Detroit, MI 48213-3496 | 2018-05-08 |
| 1245739614 | Chavela Bryant | Counselor | 18659 Griggs St, Detroit, MI 48221-1907 | 2018-02-12 |
| 1962901835 | Kendra Sibert | Counselor | 5112 Beaubien St, Detroit, MI 48202-4107 | 2018-02-06 |
| 1649787714 | Katrina Frazier | Counselor | 19968 Hubbell St, Detroit, MI 48235-1603 | 2018-01-10 |
| Find all providers in DETROIT | ||||
Please comment or provide details below to improve the information on UNIVERSITY PHYSICIAN GROUP.
| 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.