| Wayne State University Physician Group | |
|
4100 John R St, Karmanos Cancer Center-wertz Clinic, Detroit, MI 48201-2013 | |
| (800) 527-6266 | |
| (313) 576-8381 |
| Full Name | Wayne State University Physician Group |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 4100 John R St, Detroit, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336417146 | NPI | - | NPPES |
| 0P30630 | Other | MI | MEDICARE GROUP # |
| 23D1065430 | Other | MI | CLIA WAIVER |
| 0H27520 | Other | MI | BCBSM GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 4301038094 (Michigan) | Primary |
| 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 4100 John R St, Karmanos Cancer Center-wertz Clinic, Detroit, MI 48201-2013 Ph: (800) 527-6266 |
Samantha Lichocki, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5447 Woodward Ave, Detroit, MI 48202 Phone: 313-832-1100 | |
Ms. Melissa Danielle Ardery, M.A. CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5447 Woodward Ave, Detroit, MI 48202 Phone: 313-832-1100 | |
Ms. Jillian Beth Chambers, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4646 John R St, Detroit, MI 48201 Phone: 313-576-1000 | |
Mrs. Aaron Delaine Hardy-smith, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 16811 Rosemont Ave, Detroit, MI 48219 Phone: 313-595-2649 | |
Patricia Colleen Monahan Ramberger, M.A. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5447 Woodward Ave, Detroit, MI 48202 Phone: 313-832-1100 | |
Katherine Breckenridge, SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 4100 John R St, Detroit, MI 48201 Phone: 800-527-6266 | |
Mr. Arthur Knack, PH.D., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4646 John R St, Detroit, MI 48201 Phone: 313-576-1000 Fax: 313-576-1092 |