Organization
ST MARY MERCY PHYSICIAN PRACTICES
Active
Parent organization
ST MARY MERCY HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST MARY MERCY HOSPITAL
Authorized official
ARIANA GRACE RAYMOND (MANAGER PROVIDER ENROLLMENT)
(734) 343-1466
Entity
Organization
Contact information
Practice address
36475 5 MILE RD, LIVONIA, MI 48154-1971
(734) 655-4800
(734) 655-2609
Mailing address
20555 VICTOR PKWY, MAILSTOP 3A, LIVONIA, MI 48152-7031
(734) 343-9325
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010H233560
BCBS-MI PIN
MI
Enumeration date
02/19/2008
Last updated
05/04/2026
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