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General NPI Number Information
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NPI Number | 1285950295
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Entity Type | Organization
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Legal Business Name | HENRY FORD MACOMB HOSPITAL-WARREN CAMPUS
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 123 DOLPHIN AVE
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City | GALVESTON
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State | TX
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Zip | 77550-3201
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Country | US
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Telephone | 248-921-2195
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Fax |
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Provider Business Mailing Address
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Address Line | 123 DOLPHIN AVE
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City | GALVESTON
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State | TX
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Zip | 77550-3201
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Country | US
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Telephone | 248-921-2195
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Fax |
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Authorized Official
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Title or Position | MEDICAL EDUCATION ADMIN. ASSISTANT
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Name | MS. DENISE JACOB
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Credential |
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Telephone | 586-759-7641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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