Organization
BOTSFORD GENERAL HOSPITAL
Active
Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPITAL
Other names
Botsford Rheumatology
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD GENERAL HOSPITAL
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization
Contact information
Practice address
28100 GRAND RIVER AVE, SUITE 314, FARMINGTON HILLS, MI 48336-5967
(947) 521-1549
(248) 478-1827
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H299920
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/12/2006
Last updated
08/21/2019
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