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NPI Code Detail

MEDICARE: UNIVERSITY INTERNAL MEDICINE SPECIALISTS

MEDICARE: UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1972724276
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Provider Business Mailing Address
First Line : 3800 WOODWARD AVE
Second Line : SUITE 600
City : DETROIT
State : MI
Zip : 48201-2061
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 E CANFIELD ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-1804
Country : US
Telephone Number : 313-745-4525
Fax Number :
Authorized Official
Title or Position : CAO
Name : JILL G. MOORE
Credential :
Telephone Number : 313-745-8212
Provider Enumeration Date : 05/02/2007
Last Update Date : 08/22/2020

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Directions to “UNIVERSITY INTERNAL MEDICINE SPECIALISTS ” Practice Location

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