Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD PHYSICIAN ASSISTANTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD PHYSICIAN ASSISTANTS
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8147
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1060000070
MI
Other
Enumeration date
10/24/2016
Last updated
08/21/2019
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