Provider Demographics
NPI:1003878539
Name:REGENTS OF THE UNIVERSITY OF MICHIGAN
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF MICHIGAN
Other - Org Name:UNIVERSITY OF MICHIGAN HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-936-3568
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI810060261QE0700X, 282N00000X, 282NC2000X, 282NW0100X
341600000X, 3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No282NC2000XHospitalsGeneral Acute Care HospitalChildren
No282NW0100XHospitalsGeneral Acute Care HospitalWomen
No341600000XTransportation ServicesAmbulance
No3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1559423Medicaid
MI00029OtherBLUE CROSS OF MICHIGAN
MI1556483Medicaid
MI5172222Medicaid
MI1556527Medicaid
MI2775377Medicaid
MI2775377Medicaid
MI230046Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID