Graduated: 2025
NPI: 1164397345
Practice Locations (4)
HENRY FORD HEALTH PROVIDENCE HOSPITAL
1 GENESYS PKWY, SUITE 3452
GRAND BLANC, MI 484398065
2488492600
HENRY FORD HEALTH PROVIDENCE HOSPITAL
16001 W 9 MILE RD
SOUTHFIELD, MI 480754818
2484243000
HENRY FORD HEALTH PROVIDENCE HOSPITAL
16001 W 9 MILE RD 3RD FL, PROVIDENCE HOSPITAL GASTROLOGY
SOUTHFIELD, MI 480754818
2488496033
HENRY FORD HEALTH PROVIDENCE HOSPITAL
16001 W 9 MILE RD 3RD FLOOR, PROVIDENCE HOSPITAL GASTROLOGY
SOUTHFIELD, MI 480754818
2488496033
Source: CMS National Downloadable File, September 2026.