Organization
WILLIAM BEAUMONT HOSPITAL
Active
Parent organization
WILLIAM BEAUMONT HOSPITAL
Other names
BEAUMONT PROFESSIONAL SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM BEAUMONT HOSPITAL
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
44201 DEQUINDRE, TROY, MI 48085
(248) 423-2454
Mailing address
26901 BEAUMONT BLVD, COMPLIANCE, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010F36246
BCBSM
MI
Enumeration date
10/04/2006
Last updated
10/07/2021
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