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General NPI Number Information
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NPI Number | 1366486763
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Entity Type | Organization
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Legal Business Name | DETROIT MACOMB HOSPITAL CORPORATION
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7733 E JEFFERSON AVE
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City | DETROIT
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State | MI
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Zip | 48214-3707
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Country | US
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Telephone | 313-499-4254
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Fax |
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Provider Business Mailing Address
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Address Line | 7733 E JEFFERSON AVE
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City | DETROIT
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State | MI
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Zip | 48214-3707
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Country | US
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Telephone | 313-499-4254
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY MUNROE
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Credential |
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Telephone | 313-499-4108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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