OrganizationActive
Detroit Medical Center
NPI 1770869257 · Surgical Physician Assistant · Detroit, MI
Provider details
- NPI number
- 1770869257
- Entity type
- Organization
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Cheryl Kelley, Manager, Credentialing and Enrollme(313) 993-6080
- License
- 5601006086 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4201 Saint Antoine St Ste 6a
Drh University Health Center
Detroit, MI 48201-2153
Phone: (313) 745-4230
Approximate (ZIP-level) locationGet directions
Mailing address
24131 Princeton St
Dearborn, MI 48124-3264
Registry dates
- Enumerated
- 2011-10-27
- Last updated
- 2011-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.