Organization
ST JOHN HOSPITAL CORPORATION
Active
Other names
SJH surgery group
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ELLEN WHITMAN (DIRECTOR, PHYSICIAN BILLING SERVICE)
(248) 746-5822
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(586) 228-4635
(586) 228-4520
Mailing address
43800 GARFIELD RD, SUITE 201, CLINTON TWP, MI 48038-1136
(586) 228-4635
(586) 228-4520
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
MI
2086S0120X
Pediatric Surgery Physician
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OQ245330
BCBSM SURGERY GROUP
MI
Enumeration date
05/04/2006
Last updated
10/12/2007
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