Organization
ST JOHN HOSPTIAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J PALAZZOLO (VP FINANCE)
(313) 343-3558
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0260
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H260650
BLUE CROSS
—
Enumeration date
06/09/2008
Last updated
06/09/2008
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