Provider Demographics
NPI: | 1265610570 |
---|---|
Name: | REGENTS OF THE UNIVERSITY OF MICHIGAN-UHS-UNIVERSITY HEALTH SER |
Entity type: | Organization |
Organization Name: | REGENTS OF THE UNIVERSITY OF MICHIGAN-UHS-UNIVERSITY HEALTH SER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MEDICAL DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHRISTOPHER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FRANK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 734-764-7380 |
Mailing Address - Street 1: | 207 FLETCHER, ROOM 0245G |
Mailing Address - Street 2: | |
Mailing Address - City: | ANN ARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48109-1050 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-936-6390 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 207 FLETCHER, ROOM 0245G |
Practice Address - Street 2: | |
Practice Address - City: | ANN ARBOR |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48109-1050 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-936-6390 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-02-08 |
Last Update Date: | 2023-12-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207PS0010X | Allopathic & Osteopathic Physicians | Emergency Medicine | Sports Medicine | Group - Multi-Specialty |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207KA0200X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 207QA0505X | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | Group - Multi-Specialty |
No | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | Group - Multi-Specialty |
No | 207RS0010X | Allopathic & Osteopathic Physicians | Internal Medicine | Sports Medicine | Group - Multi-Specialty |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 700H11075 | Other | BLUE CROSS BLUE SHIELD MI |
MI | 0H10079 | Other | BLUE CROSS BLUE SHIELD OF MICHIGAN |
MI | 0H10078 | Other | BLUE CROSS BLUE SHIELD OF MICHIGAN |
MI | N10080 | Medicare PIN | |
MI | N10070 | Medicare PIN | |
MI | 0H10078 | Other | BLUE CROSS BLUE SHIELD OF MICHIGAN |
MI | N56780 | Medicare PIN |