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Organization
ST JOSEPH MERCY HOSPITAL
Active
Organization
ST JOSEPH MERCY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA GRACE RAYMOND (MANAGER PROVIDER ENROLLMENT)
(734) 343-1466
Entity
Organization
Contact information
Practice address
5333 MCAULEY DR, SUITE 4001, YPSILANTI, MI 48197-1014
(734) 712-3980
Mailing address
20555 VICTOR PKWY, LIVONIA, MI 48152-7031
(734) 343-3925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H111210
BS BCN SR HLTH SVCS
—
01
—
110H161810
BS BCN ACADEMIC INT MED
MI
Enumeration date
03/27/2007
Last updated
05/05/2026
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