Organization Name: | ST JOHN HOSPITAL AND MEDICAL CENTER |
NPI Number: | 1043478910 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER J PALAZZOLO (VP FINANCE) |
Mailing Address: | 26755 Ballard St Harrison Township |
State: | MI US |
Postal Code: | 480452419 |
Phone Number: | 5846555501 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2008 |
NPI Last Update Date: | 01/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |