Healthcare Provider Details

I. General information

NPI: 1134228489
Provider Name (Legal Business Name): ST. JOSEPH MERCY CHELSEA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 S MAIN ST
CHELSEA MI
48118-1383
US

IV. Provider business mailing address

775 S MAIN ST
CHELSEA MI
48118-1383
US

V. Phone/Fax

Practice location:
  • Phone: 734-475-6914
  • Fax: 734-475-7549
Mailing address:
  • Phone: 734-475-6914
  • Fax: 734-475-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBARA S FIELDER
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 734-593-5378