Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Other names
HENRY FORD PROVIDENCE HOSPITAL, PH Cardiology/Providence Hosptial and Medical Centers Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, PH CARDIOLOGY, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-4805
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060F360210
MI BCBSM GROUP
MI
Enumeration date
03/31/2006
Last updated
03/26/2026
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