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General NPI Number Information
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NPI Number | 1073774063
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Entity Type | Organization
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Legal Business Name | PONTIAC GENERAL HOSPITAL & MEDICAL CENTER
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 461 W HURON ST
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City | PONTIAC
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State | MI
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Zip | 48341-1601
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Country | US
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Telephone | 248-857-7583
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Fax |
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Provider Business Mailing Address
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Address Line | 8198 RELIABLE PKWY
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City | CHICAGO
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State | IL
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Zip | 60686-0001
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Country | US
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Telephone | 248-857-7583
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN GRAHAM
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Credential |
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Telephone | 248-857-7583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number |
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License Number State |
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