Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Other names
PH Neonatology/Providence Hosptial 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
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350F360230
MI BLUE CROSS GROUP PIN #
MI
Enumeration date
04/20/2006
Last updated
05/04/2026
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