Healthcare Provider Details

I. General information

NPI: 1952440521
Provider Name (Legal Business Name): HENRY FORD MACOMB HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30795 23 MILE RD
CHESTERFIELD MI
48047-5720
US

IV. Provider business mailing address

43421 GARFIELD RD STE 203
CLINTON TWP MI
48038-1133
US

V. Phone/Fax

Practice location:
  • Phone: 586-421-3080
  • Fax: 586-421-3081
Mailing address:
  • Phone: 586-263-2622
  • Fax: 586-263-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number363L00000X
License Number State

VIII. Authorized Official

Name: MS. KELLY RATOWSKI
Title or Position: DIRECTOR OF PROVIDER AFFAIRS
Credential:
Phone: 248-703-2003