UNIVERSITY PHYSICIAN GROUP (NPI# 1528007325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528007325 |
| 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 | 2006-06-06 |
| 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 |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | Nursing Service Providers |
| 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 SERVICE DR TOLAN PARK |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2167 |
| 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 |
| 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 | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417783 | Tawana Danielle Williams | Registered Nurse | 866 Blaine St, Detroit, MI 48202-1938 | 2020-11-08 |
| 1528684099 | Barbara Ann Bracey | Registered Nurse | 6309 Mack Ave # 48207, Detroit, MI 48207-2302 | 2020-06-22 |
| 1891325049 | Karen Elizabeth Lacombe | Registered Nurse | 2925 Russell Street, Detroit, MI 48207-4825 | 2020-01-16 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1588220222 | John S Inthavongsa | Registered Nurse | 454 W Alexandrine St Apt 18, Detroit, MI 48201-1787 | 2019-05-17 |
| 1578036083 | Prevention Safe | Registered Nurse | 15429 Appoline St, Detroit, MI 48227-4007 | 2019-01-07 |
| 1831669175 | Amber Lenay Burnett | Registered Nurse | 19650 Telegraph Rd, Detroit, MI 48219-1624 | 2018-11-29 |
| 1285117085 | Kenyata Hamilton-carter | Registered Nurse | 8136 Sirron St, Detroit, MI 48234-3314 | 2018-09-08 |
| 1003309063 | Marquita Outlaw | Registered Nurse | 8290 Coyle St, Detroit, MI 48228 | 2018-06-13 |
| 1558850768 | Doshaun Rene Edwards | Registered Nurse | 16151 Meyers Rd, Detroit, MI 48235-4108 | 2018-05-02 |
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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.