Jump to Content

Update Your Information with Us:
Professional Providers

Instructions for changing your name, address, or other information are as follows:

  • Physicians and other Individual Allied Health Practitioners must update demographic information online through the CAQH Universal Credentialing Datasource®. Visit the CAQH Web site for more information. Use the Enrollment and Change process to submit changes for network affiliations, participation, additional practice locations, and other changes not available through CAQH.
  • Group Practices and other Non-Individual Healthcare Providers: To change information about your group practice or business, use the Enrollment and Change process to submit the proper form.
  • Pharmacies: To change information on your record, please contact the DRAMS Clinical Help Desk at 800-437-3803, option 1.

Fax or mail the completed form to Provider Enrollment and Data Management.

  • FAX:
    866-900-0250
  • Mail:
    Provider Enrollment and Data Management — Mail Code B443
    Blue Cross Blue Shield of Michigan
    600 E. Lafayette Blvd.
    Detroit, MI 48226-2998


Get Adobe Reader