| Wayne State University Physician Group | |
|
3901 Beaubien St 4th Flr Carls Bldg Detroit MI 48201-2119 | |
| (313) 745-4878 | |
| (313) 993-0282 |
| Full Name | Wayne State University Physician Group |
|---|---|
| Speciality | Counselor |
| Location | 3901 Beaubien St, Detroit, Michigan |
| Authorized Official Name and Position | Jeffery P Kohlitz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2485815930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne State University Physician Group 1560 E Maple Rd Ste 400-credentialing Dept. Troy MI 48083-1138 Ph: (248) 581-5973 | Wayne State University Physician Group 3901 Beaubien St 4th Flr Carls Bldg Detroit MI 48201-2119 Ph: (313) 745-4878 |
| NPI Number | 1265647481 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265647481 | NPI | - | NPPES |
| 0H22832 | Other | MI | BCBSM GROUP # - MD/DO |
| 0H22872 | Other | MI | BCBSM GROUP # - SOCIAL WORKER |
| 0H22874 | Other | MI | BCBSM GROUP # - PSYCHOLOGIST/NEUROPSYCHOLOGIST |
| 0P32180 | Other | MI | MEDICARE GROUP # - NP |
| 0P32060 | Other | MI | MEDICARE GROUP # - PSYCHOLOGIST/NEUROPSYCHOLOGIST |
| 0P30630 | Other | MI | MEDICARE GROUP # - MD/DO |
| 0P32050 | Other | MI | MEDICARE GROUP # - SOCIAL WORKER |
| 0H228310 | Other | MI | BCBSM GROUP # - NP |
| 0H22821 | Other | MI | BCBSM GROUP # |
| 0P32120 | Other | MI | MEDICARE GROUP # - MD/DO FEE LOCALITY 99 |
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