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Organization
WILLIAM BEAUMONT HOSPITAL
Active
Organization
WILLIAM BEAUMONT HOSPITAL
Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
BEAUMONT PROFESSIONAL SERVICES/ PATHOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM BEAUMONT HOSPITAL
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 423-2454
(248) 423-2576
Mailing address
3601 W 13 MILE RD, 400-FSC PCS, ROYAL OAK, MI 48073-6712
(248) 423-2454
(248) 423-2576
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F36237
BCBSM GROUP
MI
01
—
220F362630
BCBSM
MI
Enumeration date
05/06/2006
Last updated
10/07/2021
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