Organization · Type 2 NPI

Henry Ford Health Providence Hospital

Cardiovascular Disease Physician · Southfield, MI

NPI number 1629033683 Active

Practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Call (248) 849-3306 Map

Fax (248) 849-8504

Mailing address

PO Box 670884
Detroit, MI 48267-0884

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000XNone listed
Cardiovascular Disease Physician Primary 207RC0000XNone listed
Vascular & Interventional Radiology Physician 2085R0204XNone listed
Surgery Physician 208600000XNone listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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About NPI 1629033683

Henry Ford Health Providence Hospital's National Provider Identifier is 1629033683, issued on Apr 20, 2006. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Southfield, MI. The record was last updated on Jul 16, 2026.