NPIMap

Organization Active NPI

University Internal Medicine Specialists

  • Medical Oncology Physician
  • Detroit, MI
National Provider Identifier
1063546703
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Practice address
4100 John R St
Detroit, MI 48201-2013
Phone
(313) 745-4525
NPI assigned
Mar 15, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jill G. Moore
Title
Administrator
Phone
(313) 745-8212

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X Primary

Addresses

Primary practice location

4100 John R St
Detroit, MI 48201-2013

Mailing address

3800 Woodward Ave
Suite 600
Detroit, MI 48201-2061

Other identifiers 1

IdentifierTypeStateIssuer
0H24795OtherMIBCBSM GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
University Internal Medicine Specialists11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1063546703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "313-745-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY INTERNAL MEDICINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-745-8212"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "0H24795",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.