# HENRY FORD HEALTH ST. JOHN HOSPITAL

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

## Provider details

- **NPI number:** 1285893727
- **Authorized official:** KIMBERLY CEBALT (DIRECTOR PROVIDER AFFAIRS)
- **Authorized official phone:** (313) 874-6764

## Contact information

- **Practice address:** 22101 MOROSS RD, DETROIT, MI 48236-2148
- **Practice address phone:** (313) 343-4000
- **Mailing address:** PO BOX 670884, DETROIT, MI 48267-0884
- **Mailing address phone:** (800) 999-5829
- **Mailing address fax:** (248) 641-4840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | NULL | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | — | — |
| 207RI0011X | Interventional Cardiology Physician | — | NULL | — |
| 207RI0011X | Interventional Cardiology Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080P0202X | Pediatric Cardiology Physician | — | NULL | — |
| 2080P0202X | Pediatric Cardiology Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | — | — |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 08/07/2026