Organization
ST JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J PALAZZOLO (VP FINANCE)
(313) 343-4000
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H278970
BLUE CROSS
—
Enumeration date
06/09/2008
Last updated
06/09/2008
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