Healthcare Provider Details

I. General information

NPI: 1154447522
Provider Name (Legal Business Name): UNIVERSITY SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 JOHN R ST SUITE 615
DETROIT MI
48201-2020
US

IV. Provider business mailing address

3800 WOODWARD AVE SUITE 600
DETROIT MI
48201-2061
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-4195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS FALK
Title or Position: DIRECTOR
Credential:
Phone: 313-745-4771