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Organization

WILLIAM BEAUMONT HOSPITAL

Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
BEAUMONT PROFESSIONAL SERVICES
Organization subpart
Yes

Provider details

NPI number
Legal business name
WILLIAM BEAUMONT HOSPITAL
Authorized official
LESLEY WILLBRANDT (DIRECTOR-SHARED SERVICES)
(947) 522-1911
Entity
Organization

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
26901 BEAUMONT BLVD, COMPLIANCE, SOUTHFIELD, MI 48033-4716
(947) 522-1964

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
680F372190
BCBSM
MI
Enumeration date
03/20/2007
Last updated
05/19/2021
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