Organization
ASCENSION PROVIDENCE HOSPITAL
Active
Other names
TeleMedicine/Virtual Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH STARKEL (SUPERVISOR, ENROLLMENT)
(248) 680-8121
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-2561
(248) 849-8313
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(248) 680-8000
(248) 292-3852
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
4301059442
MI
207R00000X
Internal Medicine Physician
Primary
4301056134
MI
207RI0011X
Interventional Cardiology Physician
4301058284
MI
207RP1001X
Pulmonary Disease Physician
4301067318
MI
2084N0400X
Neurology Physician
4301055579
MI
Other
Enumeration date
04/14/2015
Last updated
06/28/2022
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