University Physician Group

NPI #1316987589 in Detroit, Michigan

Provider Information

NPI Number: 1316987589
Entity Type: Organization
Organization Name: University Physician Group
Primary Specialty: Physician Assistant
Enumeration Date: Jun 7, 2006
Last Updated: Oct 26, 2016

Practice Location

Address: 4100 JOHN R ST
City: Detroit
State: Michigan
ZIP Code: 48201-2013
Phone: (313) 745-4525

Authorized Official

Name: MR. JEFFERY P KOHLITZ
Title: CHIEF FINANCIAL OFFICER
Phone: (248) 581-5930

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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