Henry Ford Wyandotte Hospital

Organization Active NPI Surgery Physician · Wyandotte, MI

NPI 1669922712 · NPPES record last updated Mar 6, 2024

Key facts

NPI
1669922712
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
HENRY FORD WYANDOTTE HOSPITAL
Practice address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone
(734) 246-6000
Fax
(734) 246-6000
NPI assigned
Oct 12, 2016
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 4

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

Practitioners 68

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

View all 68

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120920000394 MI Part B Supplier - Clinic/Group Practice 2264334499 Receives reassigned benefits from 150 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brownstown TWP, MI; Novi, MI; Southgate, MI; Wyandotte, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RC0200X
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RG0100X
Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RH0003X
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RP1001X
Surgery Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
208600000X Yes

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

1 Ford PL Ste 2E
Detroit, MI 48202-3450
Phone (313) 874-4806

Other providers in Wyandotte, MI

All providers in Wyandotte, MI · Surgery Physician in Michigan

Sources for this page

Verify at the official NPI Registry.