UNIVERSITY PHYSICIAN GROUP (NPI# 1215379938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215379938 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PHYSICIAN GROUP |
| Other Organization Name | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Practice Address |
1455 S Lapeer Rd Suite 110 Lake Orion MI 48360-1468 |
| Mailing Address |
1560 E Maple Rd Suite 400-credentialing Troy MI 48083-1138 |
| Practice Telephone | 2488147139 |
| Practice Fax Number | 2488147997 |
| Mailing Telephone | 2485815973 |
| Mailing Fax Number | 2485815640 |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2016-06-01 |
| Authorized Official Name | DIANE K STILLER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2485815943 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 4301054761 | MI | Suppliers |
| 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 |
| 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 |
| Street Address |
1455 S LAPEER RD SUITE 110 |
| City | LAKE ORION |
| State | MI |
| Zip Code | 48360-1468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386635241 | Gita K Vora | Family Medicine | 1455 S Lapeer Rd, Suite 122, Lake Orion, MI 48360-1467 | 2005-10-31 |
| 1043712896 | Renata Welker | Physical Therapist | 1455 S Lapeer Rd, Lake Orion, MI 48360-1467 | 2018-03-07 |
| 1669829057 | Gregory Jan Mcbride | Counselor | 1455 S Lapeer Rd, 175 North, Lake Orion, MI 48360-1467 | 2016-05-16 |
| 1225407943 | Oxford-orion Pllc | Clinic/Center | 1455 S Lapeer Rd, Suite 102, Lake Orion, MI 48360-1467 | 2015-09-23 |
| 1528492212 | Jerry A Dancik | Internal Medicine | 1455 S Lapeer Rd, Suite 207, Lake Orion, MI 48360-1467 | 2013-08-29 |
| 1407081078 | Orion Oxford Urgent Care Inc | General Practice | 1455 S Lapeer Rd, Lake Orion, MI 48360-1467 | 2009-05-26 |
| 1992921621 | Praveena Sampath | Pediatrics | 1455 S Lapeer Rd, Suite 134, Lake Orion, MI 48360-1467 | 2007-04-18 |
| 1215055082 | Elite Healthcare Plc | Clinic/Center | 1455 S Lapeer Rd, Ste # 102, Lake Orion, MI 48360 | 2007-03-27 |
| 1750418059 | Jennifer Manko Prohow | Family Medicine | 1455 S Lapeer Rd, Suite 100, Lake Orion, MI 48360-1467 | 2007-02-27 |
| 1851455125 | Erik David Zuckerberg | Family Medicine | 1455 S Lapeer Rd, Suite 100, Lake Orion, MI 48360-1467 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124409446 | Kyle Vires | Licensed Practical Nurse | 2271 Geyer Ct, Lake Orion, MI 48360 | 2015-06-11 |
| 1871931592 | Ihsan Asbahi | Anesthesiology | 1234 S Lapeer Rd, Lake Orion, MI 48360 | 2013-06-05 |
| 1205119567 | Michigan Bone and Joint Center | Orthopaedic Surgery | 1251 S. Lapeer Rd., Suite #102, Lake Orion, MI 48360 | 2011-09-23 |
| 1629226139 | Travis L Summerville | Physical Therapist | 1298 Walloon Way, Lake Orion, MI 48360 | 2008-09-09 |
| 1982878609 | Audrey Vizzaccaro | Physician Assistant | 1261 South Lapeer Rd, Ste 201, Lake Orion, MI 48360 | 2008-04-14 |
| 1881872265 | H & L Drugs Inc | Durable Medical Equipment & Medical Supplies | 1455 S Lapeer, Suite 101, Lake Orion, MI 48360 | 2008-02-07 |
| 1598952129 | Oakland Psychological Clinic, P.C. | Counselor | 1455 S Lapeer Rd Ste 175n, Lake Orion, MI 48360 | 2007-09-27 |
| 1700098704 | Laura Elizabeth Salome | Audiologist | 1176 S. Lapeer Rd, Lake Orion, MI 48360 | 2007-05-04 |
| 1780743658 | Frank James Iulianelli | Chiropractor | 2523 South Lapeer Road, Lake Orion, MI 48360 | 2006-12-07 |
| 1942377122 | James C Komendera Dds PC | Dentist | 1135 S Lapeer Rd, Lake Orion, MI 48360 | 2006-11-30 |
| Find all providers in zip 48360 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750752341 | Visionworks Inc. | Eyewear Supplier (Equipment, not the service) | 4925 Baldwin Rd, Bldg B, Lake Orion, MI 48359-2118 | 2015-10-08 |
| 1598931925 | Pcor LLC | Eyewear Supplier (Equipment, not the service) | 684 S Lapeer Rd, Lake Orion, MI 48362-2918 | 2008-05-06 |
| 1972638914 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 1186 S Lapeer Rd, Lake Orion, MI 48360-1430 | 2007-02-22 |
| 1447390745 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 620 N Lapeer Rd, Shops At The Shores of Long Lake, Lake Orion, MI 48362-1527 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831783 | Anthony Curtis Mcconer Sr. | Eyewear Supplier (Equipment, not the service) | 457 Highland St Se, Grand Rapids, MI 49507-1204 | 2020-11-02 |
| 1164023610 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 3355 Henry St Ste H, Muskegon, MI 49441-4393 | 2020-11-02 |
| 1316545155 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 15523 Racho Blvd, Taylor, MI 48180-5213 | 2020-10-14 |
| 1043818859 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 6828 Rochester Rd, Troy, MI 48085-1291 | 2020-10-14 |
| 1851999692 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 45101 Towne Center Blvd, Chesterfield, MI 48047-6141 | 2020-10-14 |
| 1609488378 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 4816 Bay City Rd, Midland, MI 48642 | 2020-08-23 |
| 1831700061 | Optics Center | Eyewear Supplier (Equipment, not the service) | 6645 Schaefer Rd, Dearborn, MI 48126-1812 | 2020-08-11 |
| 1538784327 | Sassy Eyes Boutique, LLC | Eyewear Supplier (Equipment, not the service) | 28911 7 Mile Rd, Livonia, MI 48152-3503 | 2020-06-08 |
| 1508407982 | P-cor LLC | Eyewear Supplier (Equipment, not the service) | 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 | 2019-10-07 |
| 1972153666 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 15620 Hall Rd, Clinton Township, MI 48038-1036 | 2019-09-16 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ORION |
| Zip Code | 48360 |
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| 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.