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General NPI Number Information
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NPI Number | 1699102244
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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 | 09/27/2013
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 2070 BIDDLE AVE SUITE 200
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City | WYANDOTTE
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State | MI
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Zip | 48192-4080
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Country | US
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Telephone | 734-225-9100
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Fax | 734-225-9176
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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 | 734-874-4806
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Fax | 138-761-3053
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery 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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand 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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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Taxonomy #6
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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