Organization
HENRY FORD WYANDOTTE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SMITH MD (SVP)
(517) 205-6407
Entity
Organization
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 324-3516
Mailing address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 324-3516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
MI
103TC0700X
Clinical Psychologist
Primary
—
—
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680H217800
BLUE CROSS BLUE SHIELD AND BLUE CARE NETWORK
MI
Enumeration date
05/18/2009
Last updated
03/06/2024
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