| Wayne State University Physician Group | |
|
16836 Newburgh Rd Livonia MI 48154-1600 | |
| (888) 362-7792 | |
| (734) 464-5885 |
| Full Name | Wayne State University Physician Group |
|---|---|
| Speciality | Social Worker |
| Location | 16836 Newburgh Rd, Livonia, Michigan |
| Authorized Official Name and Position | Jeffery P K (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. Suite 400-credentialing Dept. Troy MI 48083-1138 Ph: (248) 581-5973 | Wayne State University Physician Group 16836 Newburgh Rd Livonia MI 48154-1600 Ph: (888) 362-7792 |
| NPI Number | 1154360402 |
|---|---|
| Provider Enumeration Date | 06/05/2006 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154360402 | NPI | - | NPPES |
| 0H22872 | Other | MI | BCBSM GROUP NUMBER |
| 0P32050 | Other | MI | MEDICARE GROUP # - SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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