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Organization
WILLIAM BEAUMONT HOSPITAL
Active
Organization
WILLIAM BEAUMONT HOSPITAL
Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
Beaumont Professional Services/Thoracic Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM BEAUMONT HOSPITAL
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
3601 W 13 MILE RD, 400 FSC-PCS, ROYAL OAK, MI 48073-6712
(248) 423-3754
Mailing address
26901 BEAUMONT BLVD, COMPLIANCE, SOUTHFIELD, MI 48033-3849
(947) 522-1964
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
05/06/2006
Last updated
10/01/2021
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