Organization
HENRY FORD MEDICAL CENTER FAIRLANE
Active
Other names
Henry Ford Health System
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN DAMSCHRODER (EVP, CHIEF FIN & BUS DEV OFFICE)
(248) 648-7204
Entity
Organization
Contact information
Practice address
19401 HUBBARD DR, DEARBORN, MI 48126-2641
(313) 982-8100
Mailing address
19401 HUBBARD DR, DEARBORN, MI 48126-2641
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40033
BLUE CROSS BLUE SHIELD OF
MI
Enumeration date
08/09/2006
Last updated
03/08/2024
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