Henry Ford Health System
Organization Active NPI Surgery Physician · Detroit, MI
NPI 1508942525 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1508942525
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- 830190 (MI)
- Legal business name
- HENRY FORD HEALTH SYSTEM
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Oct 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Kelly Ratowski
- Title
- Director of Provider Affairs
- Phone
- (313) 874-4806
Other NPIs on the same Medicare enrollment 28
Corporate family (same tax ID) 24
Practitioners 90
-
Marwan S. Abouljoud, M.D.
-
Abbas Al-Kurd, MD
-
Anna Rogers Axelson, M.D.
-
Dionne Josepha Blyden, M.D.
-
Tamer Nady Boules, M.D.
-
Morris Brown, M.D.
-
Brooke M Buckley, MD
-
Arthur M. Carlin, M.D.
-
Jennifer Ashley Cirino, M.D.
-
Paul J. Corcoran, M.D.
-
Jason E. Denny, M.D.
-
Scott A. Dulchavsky, M.D., PH.D
-
Samvid A Dwivedi, D.O.
-
Robert M. Elkus, M.D.
-
Anthony J. Falvo, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000139 | MI | Part B Supplier - Clinic/Group Practice | 0547178311 |
Receives reassigned benefits from 1,862 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Novi, MI; Sterling Heights, MI; Southfield, MI; Saint Clair Shores, MI; Royal Oak, MI; Plymouth, MI; Northville, MI; Milford, MI… |
National Provider Directory
- Tax ID family
- Henry for Hospital
Locations
1961 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 319-6190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transplant Surgery Physician |
204F00000X | |||
| Surgery Physician |
208600000X | 830190 | MI | Yes |
| Surgical Critical Care Physician |
2086S0102X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Surgical Oncology Physician |
2086X0206X |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Other providers in Detroit, MI
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
All providers in Detroit, MI · Surgery Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.