Organization · Type 2 NPI

Henry Ford Health St. John Hospital

Otolaryngology Physician · St. Clair Shores, MI

NPI number 1376820605 Active

Practice location

21000 E 12 Mile Rd Ste 111
St. Clair Shores, MI 48081-1156

Call (586) 779-7610 Map

Fax (586) 779-0031

Mailing address

PO Box 670884
Detroit, MI 48267-0884

Specialties and licenses

TaxonomyCodeLicense
Allergy & Immunology (Internal Medicine) Physician 207RA0201XNone listed
Otolaryngology Physician Primary 207Y00000XNone listed
Pediatric Otolaryngology Physician 207YP0228XNone listed
Facial Plastic Surgery Physician 207YS0123XNone listed
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007XNone listed
Otology & Neurotology Physician 207YX0901XNone listed
Otolaryngology/Facial Plastic Surgery Physician 207YX0905XNone listed

Otolaryngology Physician: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injurie…

15 other providers at this address

Other otolaryngology physician providers in St. Clair Shores

See all in St. Clair Shores →

About NPI 1376820605

Henry Ford Health St. John Hospital's National Provider Identifier is 1376820605, issued on Nov 15, 2011. The primary taxonomy on file is Otolaryngology Physician (207Y00000X), and the practice location is in St. Clair Shores, MI. The record was last updated on May 19, 2026.