Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Other names
HENRY FORD SEMI MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR OF PROVIDER AFFAIRS)
(313) 874-6764
Entity
Organization
Contact information
Practice address
19925 VERNIER RD, HARPER WOODS, MI 48225-1486
(313) 245-1401
(313) 245-1492
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700H249730
BCBSM GROUP NUMBER
MI
01
—
CG3113
RAILROAD MEDICARE GROUP NUMBER
MI
01
—
CG4683
RAILROAD MEDICARE GROUP NUMBER
MI
Enumeration date
11/16/2006
Last updated
04/28/2026
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