Organization
HENRY FORD HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CONNELLY (SR VP/CFO)
(313) 876-8714
Entity
Organization
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
830190
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28018
PODIATRY (BCBS)
MI
Enumeration date
10/31/2006
Last updated
08/22/2020
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