Healthcare Provider Details

I. General information

NPI: 1518104686
Provider Name (Legal Business Name): HENRY FORD WEST BLOOMFIELD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2009
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6777 W. MAPLE
WEST BLOOMFIELD MI
48322-3013
US

IV. Provider business mailing address

6777 W. MAPLE ROAD
WEST BLOOMFIELD MI
48322-3013
US

V. Phone/Fax

Practice location:
  • Phone: 248-661-4100
  • Fax:
Mailing address:
  • Phone: 248-661-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. JOSEPH E SCHMITT III
Title or Position: SR. VICE PRESIDENT
Credential:
Phone: 313-874-4920