Organization
HENRY FORD HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE ROBERTS (MANAGER)
(248) 641-4041
Entity
Organization
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-8144
(313) 916-4460
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-8144
(313) 916-4460
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
4301072583
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4631231
—
MI
Enumeration date
04/13/2007
Last updated
08/23/2024
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