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General NPI Number Information
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NPI Number | 1518124320
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Entity Type | Organization
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Legal Business Name | HENRY FORD HEALTH MACOMB OAKLAND HOSPITAL
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 11800 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-3472
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Country | US
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Telephone | 586-573-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 28000 DEQUINDRE RD
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City | WARREN
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State | MI
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Zip | 48092-2468
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Country | US
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Telephone | 586-573-5000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR PROVIDER AFFAIRS
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Name | KIMBERLY CEBALT
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Credential |
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Telephone | 313-874-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology 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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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