UNIVERSITY PHYSICIAN GROUP NPI 1114384757

NPI Information

UNIVERSITY PHYSICIAN GROUP is an eyewear supplier in Southfield, MI. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. UNIVERSITY PHYSICIAN GROUP NPI is 1114384757. The provider is registered as an organization entity type.
The provider Is Doing Business As Wayne State University Physician Group.

The provider's business location address is:

26400 W 12 MILE RD
SUITE 60
SOUTHFIELD, MI
ZIP 48034-774
Phone: (248) 594-6702
Fax: (248) 594-6738

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 1/27/2016 and was last updated on 12/1/2016.

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:

Other Identifiers

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

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