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NPI Code Detail

MEDICARE: HENRY FORD HEALTH SYSTEM

MEDICARE: HENRY FORD HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner4704113625MI

General Provider Information

NPI Number : 1669547774
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENRY FORD HEALTH SYSTEM
Provider Business Mailing Address
First Line : 8967 LAKEVIEW DR
Second Line :
City : WHITE LAKE
State : MI
Zip : 48386-4143
Country : US
Telephone Number : 734-523-8657
Fax Number : 734-523-8667
Provider Business Practice Location Address
First Line : 29200 SCHOOLCRAFT RD
Second Line : OFFICE 2264
City : LIVONIA
State : MI
Zip : 48150-2228
Country : US
Telephone Number : 734-523-8657
Fax Number : 734-523-8667
Authorized Official
Title or Position : CARDIOLOGY NURSE PRACTITIONER
Name : MRS. MAGDALENA MARIA MAXEY
Credential : N.P. MSN APRN-C
Telephone Number : 734-523-8657
Provider Enumeration Date : 11/22/2006
Last Update Date : 08/22/2020

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