UNIVERSITY PHYSICIAN GROUP NPI 1346289147

NPI Information

NPI: 1346289147
Provider Name: UNIVERSITY PHYSICIAN GROUP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Doing Business As: WAYNE STATE UNIVERSITY PHYSICIAN GROUP
CLIA Number: 23D0701623
Address: 4100 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (313) 745-4525

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NPI Details

UNIVERSITY PHYSICIAN GROUP is a nurse practitioner in Detroit, MI. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. UNIVERSITY PHYSICIAN GROUP NPI is 1346289147. 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:

4100 JOHN R ST
DETROIT, MI
ZIP 48201-013
Phone: (313) 745-4525
Fax: (313) 576-8381

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 CLIA number assigned to this NPI record is 23D0701623 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/6/2006 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0P32180	OTHER	MICHIGAN	MEDICARE GROUP # - NP
2	0H22830	OTHER	MICHIGAN	BCBSM GROUP NUMBER
3	23D2054540	OTHER	MICHIGAN	CLIA REGISTRATION (HIGH COMPLEXITY)
4	23D1096986	OTHER	MICHIGAN	CLIA MICROSCOPY
5	0P32180	MEDICARE PIN	MICHIGAN
6	23D0650703	OTHER	MICHIGAN	CLIA COMPLIANCE DERM
7	23D0685178	OTHER	MICHIGAN	CLIA COMPLIANCE DERM
8	23D0701622	OTHER	MICHIGAN	CLIA - PPM (MODERATE COMPLEXITY)

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: 11/21/2025

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