| NPI | 1134492465 |
|---|---|
| Doing Business As | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Entity Type | Organization |
| Authorized Contact | JEFFERY P KOHLITZ Chief Financial Officer 248-581-5930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: MI 4301054761) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2016-12-01 |