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
23050 WEST RD STE 240, BROWNSTOWN TWP, MI 48183-1473
(734) 281-4197
(734) 282-0093
Mailing address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(313) 874-4806
(348) 761-3057
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YP0228X
Pediatric Otolaryngology Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28800
BLUE CROSS
MI
01
—
0H29003 AUDIOLOGIST
BLUE CROSS PIN AUDIOLOGIST
MI
Enumeration date
08/15/2014
Last updated
03/06/2024
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