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Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Other names
PH Internal Medicine/Providence Hospital and Medical Centers Inc, HENRY FORD PROVIDENCE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
(248) 849-2244
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
(248) 641-4840
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
NULL
163WD0400X
Diabetes Educator Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
251J00000X
Nursing Care Agency
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
04/19/2006
Last updated
07/16/2026
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