Healthcare Provider Details
I. General information
NPI: 1285659045
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US
IV. Provider business mailing address
3621 S STATE ST PROVIDER ENROLLMENT
ANN ARBOR MI
48108-1633
US
V. Phone/Fax
- Phone: 734-936-4000
- Fax:
- Phone: 734-647-5299
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VC0200X |
| Taxonomy | Critical Care Medicine (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | MI |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | |
| License Number State | MI |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A2900X |
| Taxonomy | Neurocritical Care Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | MI |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
CHRISTOPHER
MILLER
Title or Position: PRESIDENT
Credential:
Phone: 734-936-3568