St John Hospital Corporation

NPI #1811068760 in Detroit, Michigan

Provider Information

NPI Number: 1811068760
Entity Type: Organization
Organization Name: St John Hospital Corporation
Primary Specialty: Physician Assistant
Enumeration Date: Nov 13, 2006
Last Updated: Oct 12, 2007

Practice Location

Address: 22101 MOROSS RD
City: Detroit
State: Michigan
ZIP Code: 48236-2148
Phone: (586) 228-4635

Authorized Official

Name: SANDRA E WHITMAN
Title: DIRECTOR, PHYSICIAN BILLING SERVICE
Phone: (248) 746-5822

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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