Organization
WILLIAM BEAUMONT HOSPITAL
Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
BEAUMONT PROFESSIONAL SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM BEAUMONT HOSPITAL
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 423-2454
(248) 423-2576
Mailing address
26901 BEAUMONT BVLD, COMPLIANCE, SOUTHFIELD, MI 48033-4716
(947) 522-1964
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360F363850
BCBSM
MI
Enumeration date
04/03/2007
Last updated
10/07/2021
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