# HENRY FORD WYANDOTTE HOSPITAL

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

## Provider details

- **NPI number:** 1710315932
- **Authorized official:** MARK SMITH MD (SVP)
- **Authorized official phone:** (517) 205-6407

## Contact information

- **Practice address:** 2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
- **Practice address phone:** (734) 225-9112
- **Practice address fax:** (734) 225-9176
- **Mailing address:** 1640 FORT STREET, SUITE D ATTN DENIS, TRENTON, MI 48183
- **Mailing address phone:** (734) 391-3057
- **Mailing address fax:** (734) 391-3052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2013
- **Last updated:** 01/26/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0H28864 | BLUE CROSS | MI |