Healthcare Provider Details
I. General information
NPI: 1518918069
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2850 S INDUSTRIAL HWY SUITE 200
ANN ARBOR MI
48104-6796
US
IV. Provider business mailing address
PO BOX 223200
PITTSBURGH PA
15251-2200
US
V. Phone/Fax
- Phone: 734-971-8286
- Fax: 734-971-8922
- Phone: 734-971-8286
- Fax: 734-971-8922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
CHRISTOPHER
MILLER
Title or Position: PE SPECIALIST
Credential: MD
Phone: 734-936-3568