Healthcare Provider Details

I. General information

NPI: 1073827101
Provider Name (Legal Business Name): VHS PHYSICIANS OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29201 TELEGRAPH RD STE 404N
SOUTHFIELD MI
48034-7647
US

IV. Provider business mailing address

PO BOX 18998
BELFAST ME
04915-4084
US

V. Phone/Fax

Practice location:
  • Phone: 248-450-3507
  • Fax: 248-796-0177
Mailing address:
  • Phone: 248-455-0864
  • Fax: 708-342-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN RASMUS
Title or Position: VP, CFO TPR TENET
Credential:
Phone: 469-893-2532