Organization · NPI-2

Henry Ford Health Providence Hospital

Surgery · Southfield, MI

NPI number1942265236

StatusActive

Last updated in NPPESJul 16, 2026

Details

NPI: 1942265236
Entity type: Organization (NPI-2)
Legal business name: Henry Ford Health Providence Hospital
Organization subpart: No
Enumeration date: Apr 19, 2006
Certification date: Jul 16, 2026
Last updated: Jul 16, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208600000X	Surgery	–	–	Yes
207V00000X	Obstetrics & Gynecology	–	–
207VF0040X	Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery	–	–
207X00000X	Orthopaedic Surgery	–	–
208C00000X	Colon & Rectal Surgery	–	–
363A00000X	Physician Assistant	–	–
363L00000X	Nurse Practitioner	–	–

Other names

Ph General Surgery/Providence Hospital And Medical Centers INC (Other Name)
Henry Ford Providence Hospital (Doing Business As)

Practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Phone 248-849-3000 · Fax 248-849-2244

Mailing address

Po Box 670884
Detroit, MI 48267-0884

Phone 800-999-5829 · Fax 248-641-4840

Authorized official

Kimberly Cebalt
Director
3138746764

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