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NPI Code Detail

MEDICARE: BOTSFORD GENERAL HOSPITAL

MEDICARE: BOTSFORD GENERAL HOSPITAL
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1780819664
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOTSFORD GENERAL HOSPITAL
Provider Business Mailing Address
First Line : 26901 BEAUMONT BOULEVARD
Second Line : STE. 3D
City : SOUTHFIELD
State : MI
Zip : 48033-3849
Country : US
Telephone Number : 947-522-1857
Fax Number :
Provider Business Practice Location Address
First Line : 14001 GREENFIELD
Second Line :
City : DETROIT
State : MI
Zip : 48227-2101
Country : US
Telephone Number : 313-273-1200
Fax Number : 313-273-8130
Authorized Official
Title or Position : DIRECTOR SHARED SERVICES
Name : LESLEY WILLBRANDT
Credential :
Telephone Number : 947-522-1911
Provider Enumeration Date : 05/21/2009
Last Update Date : 02/11/2019

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Directions to “BOTSFORD GENERAL HOSPITAL ” Practice Location

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