Healthcare Provider Details

I. General information

NPI: 1487873691
Provider Name (Legal Business Name): HENRY FORD HEALTH GENESYS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S SAGINAW ST
FLINT MI
48502
US

IV. Provider business mailing address

420 S SAGINAW ST
FLINT MI
48502-1803
US

V. Phone/Fax

Practice location:
  • Phone: 810-232-3522
  • Fax: 810-762-4526
Mailing address:
  • Phone: 810-232-3522
  • Fax: 810-762-4526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: KIMBERLY CEBALT
Title or Position: MANAGER OF PROVIDER AFFAIRS
Credential:
Phone: 313-874-6764