Organization
HENR Y FORD HEALTH SYSTEM
Active
Other names
Henry Ford Health- Ortho Joint Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (MANAGER PROVIDER ENROLLMENT)
(313) 874-6764
Entity
Organization
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
08/30/2022
Last updated
11/16/2023
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