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UNIVERSITY PHYSICIAN GROUP NPI 1265472575


NPI Information

NPI: 1265472575
Provider Name: UNIVERSITY PHYSICIAN GROUP

Doing Business As: WAYNE STATE UNIVERSITY PHYSICIAN GROUP

Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization
Address:
4201 SAINT ANTOINE ST
SUITE 4C
DETROIT, MI
ZIP 48201
Phone: (313) 745-4525
Get Directions

UNIVERSITY PHYSICIAN GROUP is a dietitian registered in Detroit, MI. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. UNIVERSITY PHYSICIAN GROUP NPI is 1265472575. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wayne State University Physician Group.

The provider's business location address is:

4201 SAINT ANTOINE ST
SUITE 4C
DETROIT, MI
ZIP 48201-153
Phone: (313) 745-4525

The provider's authorized official is Jeffery P Kohlitz .
The authorized official title is Chief Financial Officer and has the following contact phone number (248) 581-5930.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 10/26/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133V00000XDietitian, RegisteredYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10P32130MEDICARE PINMICHIGAN
20P32130OTHERMICHIGANMEDICARE GROUP # - RD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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