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Organization
ST JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization
ST JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FIELD (SR DIRECTOR)
(586) 753-0011
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(586) 753-0011
Mailing address
28800 DEQUINDRE RD, WARREN, MI 48092-2466
(586) 753-0011
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0866958
BLUE CROSS
—
Enumeration date
02/24/2009
Last updated
02/24/2009
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