Henry Ford Wyandotte Hospital
Organization Active NPI Surgery Physician · Wyandotte, MI
NPI 1699102244 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1699102244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- HENRY FORD WYANDOTTE HOSPITAL
- Practice address
- 2070 Biddle Ave
Suite 200
Wyandotte, MI 48192-4080 - Phone
- (734) 225-9100
- Fax
- (734) 225-9176
- NPI assigned
- Sep 27, 2013
- Organization subpart
- No
Authorized official
- Name
- Mark Smith, MD
- Title
- SVP
- Phone
- (517) 205-6407
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 20
Practitioners 18
-
Brooke M Buckley, MD
-
Michael Douglas Callan, D.O.
-
Lance R. Chaldecott, M.D.
-
Paolo E. Di Liddo, D.P.M.
-
Anton Khlopas, MD
-
Jenna Nicole Luker, M.D., MPH
-
Glenn J Minster, M.D.
-
Henri M. Pierre-Jacques, M.D.
-
Michael E Scott, D.O.
-
Kian Setayesh, MD
-
Ferras Zeni, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Henry Ford Wyandotte
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | |||
| Orthopaedic Hand Surgery Physician |
207XS0106X | |||
| Adult Reconstructive Orthopaedic Surgery Physician |
207XS0114X | |||
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | |||
| Surgery Physician |
208600000X | Yes | ||
| Plastic and Reconstructive Surgery Physician |
2086S0122X | |||
| Foot & Ankle Surgery Podiatrist |
213ES0103X |
Addresses
Primary practice location
2070 Biddle Ave
Suite 200
Wyandotte, MI 48192-4080
Mailing address
1 Ford PL Ste 2E
Detroit, MI 48202-3450
Phone (734) 874-4806
Other providers in Wyandotte, MI
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
All providers in Wyandotte, 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 Mar 6, 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.