Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPITAL
Other names
Botsford Pediatric Assoc (NP)
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD GENERAL HOSPITAL
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization
Contact information
Practice address
23133 ORCHARD LAKE RD, SUITE 100, FARMINGTON, MI 48336-3268
(248) 477-0100
(248) 477-6153
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500F335250
BCBS
MI
Enumeration date
01/24/2008
Last updated
08/16/2019
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