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Organization
ASCENSION PROVIDENCE HOSPTIAL
Active
Organization
ASCENSION PROVIDENCE HOSPTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH STARKEL (CREDENTIALING COORDINATOR)
(248) 680-8121
Entity
Organization
Contact information
Practice address
10415 GRAND RIVER RD, 100, BRIGHTON, MI 48116-6533
(810) 227-1020
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(248) 680-8000
(248) 292-3852
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
MI
207V00000X
Obstetrics & Gynecology Physician
—
MI
Other
Enumeration date
02/14/2012
Last updated
06/28/2022
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