# ASCENSION PROVIDENCE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michigan Institute for Sleep Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578974507
- **Authorized official:** SARAH STARKEL (MANAGER)
- **Authorized official phone:** (248) 680-8121

## Contact information

- **Practice address:** 47601 GRAND RIVER AVE, OUT PATIENT CENTER D203, NOVI, MI 48374-1233
- **Practice address phone:** (248) 465-4290
- **Practice address fax:** (248) 465-4883
- **Mailing address:** 28000 DEQUINDRE RD, WARREN, MI 48092-2468
- **Mailing address phone:** (248) 680-8000
- **Mailing address fax:** (248) 292-3852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | MI | — |
| 207RP1001X | Pulmonary Disease Physician | — | MI | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | MI | Yes |

## Other

- **Enumeration date:** 05/13/2014
- **Last updated:** 06/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1235194291 | — | MH |