# ST JOHN MACOMB OAKLAND HOSPITAL

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

## Provider details

- **NPI number:** 1578891966
- **Authorized official:** SUSAN FIELD (SR. DIRECTOR)
- **Authorized official phone:** (586) 753-0275

## Contact information

- **Practice address:** 11800 E 12 MILE RD, SUITE 1829, WARREN, MI 48093-3472
- **Practice address phone:** (586) 573-5000
- **Mailing address:** 28000 DEQUINDRE RD, WARREN, MI 48092-2468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | — | Yes |

## Other

- **Enumeration date:** 11/24/2009
- **Last updated:** 04/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0E00943 | BLUE CROSS | MI |