Organization
ST JOHN HOSPITAL CORPORATION
Active
Other names
St John Registered Dietician group
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ELLEN WHITMAN (DIRECTOR)
(586) 226-6823
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(586) 228-4635
(586) 228-4520
Mailing address
43800 GARFIELD RD, 200, CLINTON TOWNSHIP, MI 48038-1136
(586) 228-4635
(586) 228-4520
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OQ262160
BCBSM GROUP
MI
Enumeration date
03/13/2007
Last updated
10/12/2007
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