Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPITAL
Other names
Botsford Pediatrics
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
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350F378030
BLUE CROSS
MI
01
—
G4732F
BCN
MI
Enumeration date
06/11/2006
Last updated
08/16/2019
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