Organization
BOTSFORD GENERAL HOSPITAL
Active
Other names
Botsford Oncology Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization
Contact information
Practice address
28080 GRAND RIVER AVE, SUITE 306, FARMINGTON HILLS, MI 48336-5966
(248) 471-8182
(248) 478-7179
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110Q246120
BLUE CROSS
MI
05
—
2877555
—
MI
Enumeration date
06/30/2006
Last updated
08/21/2019
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