UNIVERSITY PHYSICIAN GROUP


Address: 3901 Chrysler Service Dr, Tolan Park, Detroit, MI 48201-2167
Phone: 8883627792

UNIVERSITY PHYSICIAN GROUP (NPI# 1326087685) 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) 1326087685
Entity Type Organization
Organization Name UNIVERSITY PHYSICIAN GROUP
Other Organization Name WAYNE STATE UNIVERSITY PHYSICIAN GROUP
Practice Address 3901 Chrysler Service Dr
Tolan Park
Detroit
MI 48201-2167
Mailing Address 1560 E Maple Rd
Suite 400-credentialing Dept.
Troy
MI 48083-1138
Practice Telephone 8883627792
Practice Fax Number 3139933421
Mailing Telephone 2485815973
Mailing Fax Number 2485815640
Enumeration Date 2006-06-05
Last Update Date 2016-10-26
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 101Y00000X Counselor Behavioral Health & Social Service Providers

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
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

Office Location

Street Address 3901 CHRYSLER SERVICE DR
TOLAN PARK
City DETROIT
State MI
Zip Code 48201-2167

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821036989 Gary Lyn Rhodes Psychologist 3901 Chrysler Service Dr, Detroit, MI 48201-2167 2006-06-02
1629634878 Shameer Mehdikhan Student in an Organized Health Care Education/Training Program 3901 Chrysler Service Dr, Detroit, MI 48201 2019-05-14
1992239560 Sandra Helena Reyes Student in an Organized Health Care Education/Training Program 3901 Chrysler Service Dr, Suite 5-a, Detroit, MI 48201 2017-04-20
1639603269 Justin Gray Student in an Organized Health Care Education/Training Program 3901 Chrysler Service Dr, Detroit, MI 48201 2017-04-20
1316470347 Tyler Joseph William Hecht Student in an Organized Health Care Education/Training Program 3901 Chrysler Service Dr, Suite 5-a, Detroit, MI 48201 2017-04-06
1568822963 Manisha Leary Social Worker 3901 Chrysler Service Dr, Detroit, MI 48201-2167 2016-02-26
1932596731 Takako Benn Psychiatry & Neurology 3901 Chrysler Service Dr, Suite 5-a, 538.4, Detroit, MI 48201 2015-04-20
1346631470 Lacretia Fisher Registered Nurse 3901 Chrysler Service Dr, Tolan Park, Detroit, MI 48201-2167 2015-02-11
1285950212 Lydia C Ditirro Psychiatry & Neurology 3901 Chrysler Service Dr, Tolan Park, Detroit, MI 48201-2167 2010-04-15
1720257207 Walter Otto Siegl Social Worker 3901 Chrysler Service Dr, Tolan Park, Detroit, MI 48201-2167 2008-02-28
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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 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City DETROIT
Zip Code 48201

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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