# HENRY FORD HOSPITAL

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

## Provider details

- **NPI number:** 1104040609
- **Authorized official:** JODIE ROBERTS (MANAGER)
- **Authorized official phone:** (248) 641-4041

## Contact information

- **Practice address:** 2799 W GRAND BLVD, DETROIT, MI 48202-2608
- **Practice address phone:** (313) 916-8144
- **Practice address fax:** (313) 916-4460
- **Mailing address:** 2799 W GRAND BLVD, DETROIT, MI 48202-2608
- **Mailing address phone:** (313) 916-8144
- **Mailing address fax:** (313) 916-4460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 4301072583 | MI | Yes |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 08/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4631231 | — | MI |