Organization
BOTSFORD GENERAL HOSPTIAL
Active
Other names
Comprehensive OBGYN - Dearborn Heights
Organization subpart
No
Provider details
NPI number
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
27031 W WARREN ST, DEARBORN HEIGHTS, MI 48127-1901
(313) 561-1913
(313) 561-2196
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OF37116
BLUE CROSS
MI
Enumeration date
06/10/2006
Last updated
10/18/2021
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