Organization
ST. JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J PALAZZOLO (V.P. - FINANCE)
(313) 343-3558
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(586) 753-0011
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0011
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H21704
BCBSM PIN
MI
Enumeration date
03/09/2007
Last updated
06/25/2008
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