Organization
ST JOHN PROVIDENCE HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WIEMANN M.D. (EXECUTIVE VICE PRESIDENT)
(248) 849-3100
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3430
Mailing address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
MI
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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