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General NPI Number Information
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NPI Number | 1295011138
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Entity Type | Organization
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Legal Business Name | HENRY FORD MEDICAL CENTER COLUMBUS
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 39450 W 12 MILE RD
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City | NOVI
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State | MI
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Zip | 48377-3600
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Country | US
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Telephone | 248-344-7380
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Fax | 248-344-6699
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Provider Business Mailing Address
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Address Line | 2457 WASHINGTON AVE
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2963
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Country | US
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Telephone | 248-344-7380
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Fax | 248-344-6699
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. LYNNE ASHLEY STEWART
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Credential | ANP-BC
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Telephone | 248-344-7380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 4704196861
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License Number State | MI
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