# ST JOHN MACOMB OAKLAND HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013174655
- **Authorized official:** RANDOLPH KRUMMLER (VP FINANCE)
- **Authorized official phone:** (586) 573-5910

## Contact information

- **Practice address:** 7733 E JEFFERSON AVE, DETROIT, MI 48214-3707
- **Practice address phone:** (313) 499-4000
- **Mailing address:** 28000 DEQUINDRE RD, WARREN, MI 48092-2468
- **Mailing address phone:** (586) 753-0275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/21/2008
- **Last updated:** 05/21/2008