Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Other names
Henry Ford EKG Reads, PH EKG reads
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
(248) 641-4840
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240F370640
MI BLUE CROSS GROUP PIN #
MI
Enumeration date
04/19/2006
Last updated
07/16/2026
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