St Joseph Mercy Hospital

NPI #1396864849 in Ypsilanti, Michigan

Provider Information

NPI Number: 1396864849
Entity Type: Organization
Organization Name: St Joseph Mercy Hospital
Primary Specialty: Physician Assistant
Enumeration Date: Mar 28, 2007
Last Updated: Oct 5, 2017

Practice Location

Address: 5301 E HURON RIVER DRIVE
Address 2: SURGERY, MEDICAL
City: Ypsilanti
State: Michigan
ZIP Code: 48197-1051
Phone: (734) 712-7202

Authorized Official

Name: MICHAEL P GUSHO
Title: CFO SE MI REGION
Phone: (248) 858-6174

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant - Surgical — Surgical	363AS0400X
Physician Assistant	363A00000X	Primary

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