Organization
ST JOSEPH MERCY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA GRACE RAYMOND (MANAGER PROVIDER ENROLLMENT)
(734) 343-1466
Entity
Organization
Contact information
Practice address
5301 E HURON RIVER DR, PATHOLOGY DEPARTMENT, YPSILANTI, MI 48197-1051
(734) 712-5989
Mailing address
34505 W 12 MILE RD STE 200, FARMINGTON HILLS, MI 48331-3286
(734) 343-3922
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220H161560
BS BCN PATHOLOGY
MI
Enumeration date
03/28/2007
Last updated
05/05/2026
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