# HENRY FORD MEDICAL CENTER FAIRLANE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Henry Ford Health System
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538179551
- **Authorized official:** ROBIN DAMSCHRODER (EVP, CHIEF FIN & BUS DEV OFFICE)
- **Authorized official phone:** (248) 648-7204

## Contact information

- **Practice address:** 19401 HUBBARD DR, DEARBORN, MI 48126-2641
- **Practice address phone:** (313) 982-8100
- **Mailing address:** 19401 HUBBARD DR, DEARBORN, MI 48126-2641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 03/08/2024