Organization
HENRY FORD SHAPED BEAM SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA WINESKI (MANAGER)
(313) 916-1078
Entity
Organization
Contact information
Practice address
2799 W GRAND BLVD # M216, DETROIT, MI 48202-2608
(313) 916-1078
(313) 916-3235
Mailing address
2799 W GRAND BLVD. #M216, DETROIT, MI 48202
(313) 916-1078
(313) 916-3235
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H21883
BLUE CROSS
MI
01
—
514930
HAP
MI
Enumeration date
01/18/2007
Last updated
08/22/2020
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