UNIVERSITY PHYSICIAN GROUP


Address: 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085
Phone: 3134297977

UNIVERSITY PHYSICIAN GROUP (NPI# 1992044598) 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) 1992044598
Entity Type Organization
Organization Name UNIVERSITY PHYSICIAN GROUP
Other Organization Name WAYNE STATE UNIVERSITY PHYSICIAN GROUP
Practice Address 18100 Oakwood Blvd
Suite 300
Dearborn
MI 48124-4085
Mailing Address 1560 E Maple Rd
Suite 400-credentialing
Troy
MI 48083-1138
Practice Telephone 3134297977
Practice Fax Number 3134297981
Mailing Telephone 2485815973
Mailing Fax Number 2485815640
Enumeration Date 2013-02-04
Last Update Date 2016-12-01
Authorized Official Name MR. JEFFERY P KOHLITZ (CHIEF FINANCIAL OFFICER)
Authorized Official Telephone 2485815930
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335E00000X Prosthetic/Orthotic Supplier 4301028224 MI Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
MI NGS 5717980007 01

Other Provider/Organization Names

Other Name Type Code
Wayne State University Physician Group Doing Business As Name - Organization

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
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
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 18100 OAKWOOD BLVD
SUITE 300
City DEARBORN
State MI
Zip Code 48124-4085

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578535142 Lawrence G Morawa Orthopaedic Surgery 18100 Oakwood Blvd, 300, Dearborn, MI 48124-4085 2006-02-07
1992110522 Michelle T Leonard Psychologist 18100 Oakwood Blvd, C/o Michelle Leonard, Dearborn, MI 48124-4085 2014-06-23
1801215959 Lassen Dialysis LLC Clinic/Center 18100 Oakwood Blvd, Ste 206, Dearborn, MI 48124-4085 2014-04-15
1851630206 University Physician Group Occupational Therapist 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 2013-02-05
1073878682 Tiona Kimisha Stephens Internal Medicine 18100 Oakwood Blvd, Site 01 Medical Education, Dearborn, MI 48124-4085 2012-07-10
1598052441 Geoffrey Alan Potts Dermatology 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 2011-06-29
1346565355 Mariana Dimovski Atanasovski Dermatology 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4089 2010-04-01
1821310806 Oakwood Healthcare Inc Clinic/Center 18100 Oakwood Blvd, Suite 206, Dearborn, MI 48124-4085 2010-02-18
1114257540 Dynamic Urocare PC Urology 18100 Oakwood Blvd, Ste 315, Dearborn, MI 48124-4085 2010-01-07
1023248085 Violet Asfour Internal Medicine 18100 Oakwood Blvd, Dearborn, MI 48124-4085 2009-07-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396389524 Pharma A, LLC Pharmacy 23916 Michigan Ave, Dearborn, MI 48124 2019-10-31
1225683725 Aysha Said Behavior Technician 1369 Porter St, Dearborn, MI 48124 2019-08-02
1881257772 Leen Nusairat Internal Medicine Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 2019-04-17
1417413360 Gary C. Veraghen, Dds, PC Dentist 22100 W. Outer Drive, Dearborn, MI 48124 2019-02-15
1982168787 Fnu Asma Manzar Physical Therapist Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 2019-01-25
1639640162 Jernia Lashawn Usher Behavior Technician 1360 Porter St Lower Level, Dearborn, MI 48124 2018-12-10
1710456470 Samar Fouad Hannawi Psychologist 3815 Pelham Street, Suite #13, Dearborn, MI 48124 2018-11-24
1881178747 Sarah Chehab Psychologist 835 Mason St Suite 220b, Dearborn, MI 48124 2018-09-17
1568948289 Ibrahim M Basma Pharmacist 22521 Michigan Avenue, Dearborn, MI 48124 2018-07-16
1669961942 Jacqueline E Domzalski Technician, Other 3231 S. Gulley, Suite E, Dearborn, MI 48124 2018-05-02
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Taxonomy Information

Taxonomy Code 335E00000X
Grouping Suppliers
Classification Prosthetic/Orthotic Supplier

Taxonomy Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285151480 Binson's Hospital Supplies, Inc. Prosthetic/Orthotic Supplier 5250 Auto Club Dr Ste 130, Dearborn, MI 48126-2619 2017-08-28
1912075748 Americare Medical Supplies Inc Prosthetic/Orthotic Supplier 5468 Schaefer Rd, Dearborn, MI 48126-3223 2006-12-01
1750877627 Michigan Surgery Specialists, P.C. Prosthetic/Orthotic Supplier 22731 Newman St Ste 100b, Dearborn, MI 48124 2018-07-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578178026 Teter Orthotics & Prosthetics, Inc Prosthetic/Orthotic Supplier 106 S Greenville West Dr Ste 3, Greenville, MI 48838-3504 2020-09-11
1508474297 Brandy Denise Smith-bounds Prosthetic/Orthotic Supplier 41660 Huntington Dr, Sterling Heights, MI 48313-3128 2020-07-19
1912537705 The W Beauty and Barber Lounge Prosthetic/Orthotic Supplier 18718 Grand River Ave, Detroit, MI 48223-2215 2020-01-21
1710520507 Michigan Surgery Specialists, P.C. Prosthetic/Orthotic Supplier 19725 Allen Rd Ste B, Brownstown Twp, MI 48183-1090 2019-10-24
1952962003 Best Choice Senior Services, Inc Prosthetic/Orthotic Supplier 27177 Lahser Rd Ste 206, Southfield, MI 48034-8468 2019-06-27
1124686704 Bionic Prosthetics and Orthotics Group LLC Prosthetic/Orthotic Supplier 2550 Niles Rd Ste 1, Saint Joseph, MI 49085-3270 2019-05-30
1972066348 Jan J Stokosa Prosthetic/Orthotic Supplier 2145 University Park Drive, Suite 100, Okemos, MI 48864 2019-04-11
1306304670 Ddp Mobility and Safety Medical Equipment Prosthetic/Orthotic Supplier 27258 Cecile St, Dearborn Heights, MI 48127-3393 2019-03-06
1538626221 Crossroads Orthotics & Consultation, Inc. Prosthetic/Orthotic Supplier 4025 Holt Rd Ste 110, Holt, MI 48842-6019 2019-02-28
1952886343 Confidence Beyond Hair Loss Prosthetic/Orthotic Supplier 14830 Lakeshore Dr, Grand Haven, MI 49417-8636 2018-10-01
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Competitor

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City DEARBORN
Zip Code 48124

Improve Information

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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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