1982036828 NPI number — INSTITUTE FOR POPULATION HEALTH

Table of content: PROF. LAUREN DIANA JOHNSON DOULA (NPI 1952057077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982036828 NPI number — INSTITUTE FOR POPULATION HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTE FOR POPULATION HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982036828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1151 TAYLOR ST
Provider Second Line Business Mailing Address:
334C
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48202-1732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-324-9595
Provider Business Mailing Address Fax Number:
313-876-0309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1151 TAYLOR ST
Provider Second Line Business Practice Location Address:
334C
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-324-9595
Provider Business Practice Location Address Fax Number:
313-876-0309
Provider Enumeration Date:
08/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MATHEWS
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
313-324-9595

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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