| NPI | 1275572075 |
|---|---|
| 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 | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-10-26 |