Organization
PROVIDENCE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER MICHAEL RYDESKY M.D. (RESIDENT)
(248) 849-3216
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-2203
Mailing address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
08/22/2020
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