Henry Ford Wyandotte Hospital

Organization Active NPI Obstetrics & Gynecology Physician · Wyandotte, MI

NPI 1457586646 · NPPES record last updated Mar 6, 2024

Key facts

NPI
1457586646
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
HENRY FORD WYANDOTTE HOSPITAL
Practice address
2333 Biddle Ave
Wyandotte, MI 48192
Phone
(734) 324-3516
NPI assigned
May 18, 2009
Organization subpart
No

Authorized official

Name
Mark Smith, MD
Title
SVP
Phone
(517) 205-6407

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 324

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 324

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040227000431 MI Part B Supplier - Clinic/Group Practice 2264334499 Receives reassigned benefits from 245 practitioners
3 other NPIs on this enrollment
Practice locations: Rockwood, MI; Wyandotte, MI; Trenton, MI; Southgate, MI; Novi, MI; Brownstown TWP, MI; Allen Park, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X MI Yes
Gynecologic Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207VX0201X
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208800000X
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192

Mailing address

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 324-3516

Other identifiers

IdentifierTypeStateIssuer
160Q246570OtherMIBLUE CROSS BLUE SHIELD AND BLUE CARE NETWORK

Other providers in Wyandotte, MI

All providers in Wyandotte, MI · Obstetrics & Gynecology Physician in Michigan

Sources for this page

Verify at the official NPI Registry.