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NPI 1386679892 · Health Maintenance Organization · Southfield, MI
Provider details
- NPI number
- 1386679892
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Frederick Lewerenz, Physician(248) 443-8100
- License
- 5101006349 (MI)
Specialties & taxonomies
Managed Care Organizations
Practice location
24361 Greenfield Rd
115
Southfield, MI 48075-3139
Phone: (248) 443-8100
Fax: (248) 443-8120
Approximate (ZIP-level) locationGet directions
Mailing address
24361 Greenfield Rd
Southfield, MI 48075-3139
Registry dates
- Enumerated
- 2006-07-12
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.