Organization
ASCENSION MEDICAL GROUP MICHIGAN
Active
Other names
HENRY FORD SEMI MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL R PERRY (MANAGER)
(248) 221-1918
Entity
Organization
Contact information
Practice address
46591 ROMEO PLANK RD, SUITE 205, MACOMB, MI 48044-5742
(586) 226-6250
(586) 226-6204
Mailing address
PO BOX 14129, BELFAST, ME 04915-4032
(248) 680-8000
(248) 292-3852
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E01172
BCBSM GROUP NUMBER
MI
01
—
CG3113
RAILROAD MEDICARE GROUP NUMBER
MI
Enumeration date
11/17/2006
Last updated
04/16/2025
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