Graduated: 2000
NPI: 1134346281
Practice Locations (2)
HENRY FORD HEALTH PROVIDENCE HOSPITAL
1 GENESYS PKWY, SUITE 3452
GRAND BLANC, MI 484398065
2488492600
HENRY FORD HEALTH PROVIDENCE HOSPITAL
1400 GENESYS PKWY, B136
GRAND BLANC, MI 484398068
8106067629
Source: CMS National Downloadable File, September 2026.