Organization
ST JOSEPH MERCY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA GRACE RAYMOND (MANAGER PROVIDER ENROLLMENT)
(734) 343-1466
Entity
Organization
Contact information
Practice address
5301E HURON RIVER DR, PEDIATRICS DEPARTMENT, YPSILANTI, MI 48197-1051
(734) 712-3325
Mailing address
34505 W 12 MILE RD STE 200, FARMINGTON HILLS, MI 48331-3286
(734) 343-3922
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700H161150
BS BCN PEDS
MI
Enumeration date
03/28/2007
Last updated
05/05/2026
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