Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPITAL
Other names
Botsford Podiatry Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD GENERAL HOSPITAL
Authorized official
NANCY SUSICK (CHIEF OPERATING OFFICER)
(947) 522-3338
Entity
Organization
Contact information
Practice address
28100 GRAND RIVER AVE, SUITE 301, FARMINGTON HILLS, MI 48336-5967
(947) 521-1320
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H299920
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/17/2006
Last updated
05/16/2023
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