Update your information

Here's how to let us know your name, address or other contact information has changed:

  • Physicians and other Individual Allied Health Practitioners located in Michigan must update demographic information online through the CAQH Universal Credentialing Datasource®. Visit the CAQH website 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, Non-Hospital Facilities and other Non-Individual Health Care Providers located in Michigan: 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 Pharmacy Services Clinical Help Desk:

1-800-437-3803, option 1

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

Mailing address:
Provider Enrollment and Data Management
Blue Cross Blue Shield of Michigan
P.O. Box 217
Southfield, MI 48034

Fax: 1-866-900-0250

©1996-2015 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.

State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted.

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