Healthcare Provider Details

I. General information

NPI: 1679917538
Provider Name (Legal Business Name): UNITED PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30800 TELEGRAPH RD STE 2800
BINGHAM FARMS MI
48025-5704
US

IV. Provider business mailing address

30800 TELEGRAPH RD STE 2800
BINGHAM FARMS MI
48025-5704
US

V. Phone/Fax

Practice location:
  • Phone: 248-593-0100
  • Fax: 248-593-0200
Mailing address:
  • Phone: 248-593-0100
  • Fax: 248-593-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704248417
License Number StateMI

VIII. Authorized Official

Name: MS. KATHERINE DAY
Title or Position: MANAGER, CARE MANAGEMENT
Credential: RN
Phone: 248-593-0100