Healthcare Provider Details

I. General information

NPI: 1982853560
Provider Name (Legal Business Name): HENRY FORD WYANDOTTE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 BIDDLE AVE
WYANDOTTE MI
48192-4668
US

IV. Provider business mailing address

2333 BIDDLE AVE
WYANDOTTE MI
48192-4668
US

V. Phone/Fax

Practice location:
  • Phone: 734-246-6000
  • Fax: 734-246-6986
Mailing address:
  • Phone: 734-246-6000
  • Fax: 734-246-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number820230
License Number StateMI

VIII. Authorized Official

Name: ROBIN S. DAMSCHRODER
Title or Position: EVP, FIN AND BUS DEV OFFICER
Credential:
Phone: 313-876-8452