Organization
WILLIAM BEAUMONT HOSPITAL
Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
BEAUMONT PROFESSIONAL SERVICES/PEDIATRICS
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) 585-8271
(248) 585-8266
Mailing address
26901 BEAUMONT BLVD, COMPLIANCE, SOUTHFIELD, MI 48033-4716
(947) 522-1964
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F36132
BCBSM
MI
Enumeration date
05/09/2006
Last updated
05/19/2021
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