Healthcare Provider Details

I. General information

NPI: 1235444969
Provider Name (Legal Business Name): DMC EDUCATION & RESEARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST 9C UHC
DETROIT MI
48201-2153
US

IV. Provider business mailing address

20 BURTON HILLS BLVD ATTN: CAROL BAILEY
NASHVILLE TN
37215-6197
US

V. Phone/Fax

Practice location:
  • Phone: 615-665-6006
  • Fax: 313-966-0880
Mailing address:
  • Phone: 615-665-6000
  • Fax: 615-665-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAROL A BAILEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-665-6000