Organization
HENRY FORD HEALTH ST. JOHN HOSPITAL
Active
Other names
Medical Resources Group, Henry Ford St John Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
231H00000X
Audiologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E031610
BCBS GROUP NUMBER
MI
Enumeration date
07/10/2010
Last updated
03/17/2026
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