MEDICARE: HENRI GODBOLD M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	4301080800	MI
2	207R00000X	Internal Medicine Physician	4301080800	MI
3	208000000X	Pediatrics Physician	4301080800	MI

General Provider Information

NPI Number	:	1407012834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRI GODBOLD M.D

Provider Business Mailing Address
First Line	:	18000 W 9 MILE RD STE 200
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-4020
Country	:	US
Telephone Number	:	248-336-4000
Fax Number	:	248-336-9137

Provider Business Practice Location Address
First Line	:	20901 W 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48219-1904
Country	:	US
Telephone Number	:	313-564-5510
Fax Number	:	248-581-8839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	12/16/2025

Similar Medicare Providers

1942263843 — DR. IRVIN J. GASTMAN DO, PHD
Practice Location Address:

20901 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-564-5510
Practice Fax: 248-336-9137

1992202790 — MR. BRYAN ADAM HNATIO PA-C
Practice Location Address:

20901 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-564-5510
Practice Fax: 248-336-9137

1518626902 — ROSILIN JOSEPH NP
Practice Location Address:

20901 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-564-5510
Practice Fax: 248-336-9137

1275343238 — KYLEE AHLSTEDT PA-C
Practice Location Address:

20901 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-564-5510
Practice Fax: 248-336-9137

1629169958 — FELICIA L. MARSH LLMSW
Practice Location Address:

20955 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-255-3911
Practice Fax:

1891871398 — EXTENDED CARE PHASE II
Practice Location Address:

20955 W 7 MILE RD
DETROIT, MI
48219-1904

Practice Phone: 313-255-3911
Practice Fax:

Directions to “ HENRI GODBOLD M.D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.