Organization
ST MARY MERCY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PAUL GUSHO (REGIONAL CFO)
(734) 398-0642
Entity
Organization
Contact information
Practice address
19000 ST JOES PKWY STE 100, LIVONIA, MI 48152-1477
(734) 743-4656
(734) 743-4369
Mailing address
20555 VICTOR PKWY, LIVONIA, MI 48152-7031
(734) 343-3925
(312) 957-3997
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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