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Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR OF PROVIDER AFFAIRS)
(313) 874-6764
Entity
Organization
Contact information
Practice address
21000 E 12 MILE RD, SUITE 105, SAINT CLAIR SHORES, MI 48081-1116
(586) 498-3606
(586) 498-3601
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
—
MI
208000000X
Pediatrics Physician
—
MI
261QU0200X
Urgent Care Clinic/Center
Primary
—
MI
363A00000X
Physician Assistant
—
MI
Other
Enumeration date
07/12/2013
Last updated
04/28/2026
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