Organization
HENRY FORD WYANDOTTE HOSPITAL
Active
Other names
HENRY FORD HEALTH CENTER BROWNSTOWN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY GOODBALIAN (CFO)
(734) 246-6044
Entity
Organization
Contact information
Practice address
2333 BIDDLE ST, WYANDOTTE, MI 48192-4668
(734) 246-6000
(734) 246-6986
Mailing address
23050 WEST RD, BROWNSTOWN TWP, MI 48183-1472
(734) 287-9880
(734) 246-6986
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
826849
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40013
BLUE CROSS
MI
Enumeration date
09/24/2007
Last updated
07/23/2015
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