Provider Demographics
NPI:1871669630
Name:PHYSICIANS GROUP
Entity Type:Organization
Organization Name:PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-350-0027
Mailing Address - Street 1:1850 EASTGATE RD
Mailing Address - Street 2:SUITE NUMBER C
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3082
Mailing Address - Country:US
Mailing Address - Phone:313-350-0027
Mailing Address - Fax:248-865-7356
Practice Address - Street 1:1850 EASTGATE RD
Practice Address - Street 2:SUITE NUMBER C
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3082
Practice Address - Country:US
Practice Address - Phone:313-350-0027
Practice Address - Fax:248-865-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG52212Medicare UPIN