| Ascension St John Hospital | |
|
22101 Moross Rd Detroit MI 48236-2148 | |
| (586) 753-0011 | |
| Not Available |
| Full Name | Ascension St John Hospital |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 22101 Moross Rd, Detroit, Michigan |
| Authorized Official Name and Position | Christopher J Palazzolo (V.P. - FINANCE) |
| Authorized Official Contact | 3133433558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension St John Hospital 28000 Dequindre Rd Warren MI 48092-2468 Ph: (248) 680-8000 | Ascension St John Hospital 22101 Moross Rd Detroit MI 48236-2148 Ph: (586) 753-0011 |
| NPI Number | 1023149473 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 03/31/2020 |
| Certification Date | 03/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023149473 | NPI | - | NPPES |
| 0Q24564 | Other | MI | BCBSM PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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