University Physician Group

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

4301054761 Issued in MI

Legal business name

UNIVERSITY PHYSICIAN GROUP

Practice address

4700 Schaefer Rd
Suite 165
Dearborn, MI 48126-3698

Phone

(313) 945-7724

Fax

(313) 945-8731

NPI assigned

Oct 13, 2010

Organization subpart

No

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

Authorized official

Name

Diane K Stiller

Title

Chief Financial Officer

Phone

(248) 581-5943

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1740590678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E. MAPLE RD.",
            "address_2": "SUITE 400-CREDENTIALING DEPT.",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "248-581-5973",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SCHAEFER RD",
            "address_2": "SUITE 165",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263698",
            "telephone_number": "313-945-7724",
            "fax_number": "313-945-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "STILLER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "248-581-5943"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "4301054761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NGS",
            "identifier": "5717980004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• United Specialty Pharmacy LLC
• Unity Min LLC
• University Home Care Agency LLC
• University Neurosurgical Associates, PC
• University Physician Group
• University Physician Group
• University Physician Group
• Uop LLC
• Uop Management Services, LLC
• Sarah Upshur, PA-C

• Eyewear Supplier in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Eyewear Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.