NPI 1457390254
University Physician Group
Practice location
- Address
- 4201 Saint Antoine St. Suite 8d, Detroit, MI 48201
- Phone
- (313) 745-4275
- Mailing address
- 3800 Woodward Ave Suite 600, Detroit, MI 48201-2061
Authorised official
- Name
- Kenneth P. Lee
- Title
- Chief Administrative Officer
- Phone
- (313) 577-8112
Registered specialties
Clinical Neuropsychologist
Primary
Registry record
- NPI
- 1457390254
- Entity type
- Organization
- NPI issued
- 6 Jun 2006
- Record last updated
- 12 Dec 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.