Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPTIAL
Other names
Farmington Village Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD GENERAL HOSPTIAL
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization
Contact information
Practice address
28100 GRAND RIVER AVE STE 313S, FARMINGTON HILLS, MI 48336-5970
(947) 521-7150
(248) 426-2473
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080F321610
BLUE CROSS
MI
05
—
3473334
—
MI
01
—
G4727F
BLUE CARE NETWORK
MI
Enumeration date
06/28/2006
Last updated
08/21/2019
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