University Physician Group
Prosthetic/Orthotic Supplier in Dearborn, MI. Organization (NPI-2).
Details
- NPI
- 1992044598
- Entity type
- Organization (NPI-2)
- Legal business name
- University Physician Group
- Organization subpart
- No
- Enumeration date
- Feb 4, 2013
- Last updated
- Dec 1, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | 4301028224 | MI | Yes |
Other names
- Wayne State University Physician Group (Doing Business As)
Practice location
18100 Oakwood BlvdSuite 300
Dearborn, MI 48124-4085
Phone 313-429-7977 · Fax 313-429-7981
Mailing address
1560 E Maple RdSuite 400-Credentialing
Troy, MI 48083-1138
Phone 248-581-5973 · Fax 248-581-5640
Authorized official
Jeffery P Kohlitz
Chief Financial Officer
2485815930
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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