Organization
ST JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MACKENZIE (CRNA)
(586) 725-3106
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4766
Mailing address
35597 BROOKE CT, NEW BALTIMORE, MI 48047-1137
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
4704125071
MI
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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