Provider Demographics
NPI:1750653655
Name:UNITED PHYSICIANS SUPPORT SOLUTIONS, LLC
Entity type:Organization
Organization Name:UNITED PHYSICIANS SUPPORT SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-593-0143
Mailing Address - Street 1:30800 TELEGRAPH RD
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4542
Mailing Address - Country:US
Mailing Address - Phone:248-593-0100
Mailing Address - Fax:248-593-0117
Practice Address - Street 1:30800 TELEGRAPH RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4542
Practice Address - Country:US
Practice Address - Phone:248-593-0100
Practice Address - Fax:248-593-0117
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED PHYSICIANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty