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General NPI Number Information
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NPI Number | 1568861557
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Entity Type | Organization
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Legal Business Name | HENRY FORD WYANDOTTE HOSPITAL
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 23050 WEST RD STE 240
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City | BROWNSTOWN TWP
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State | MI
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Zip | 48183-1473
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Country | US
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Telephone | 734-281-4197
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Fax | 734-282-0093
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 2E
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-874-4806
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Fax | 348-761-3057
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Authorized Official
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Title or Position | SVP
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Name | MARK SMITH
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Credential | MD
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Telephone | 517-205-6407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology 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 | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy 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 | 231H00000X
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Taxonomy Name | Audiologist
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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