Provider Demographics
NPI:1487873691
Name:HENRY FORD HEALTH GENESYS HOSPITAL
Entity type:Organization
Organization Name:HENRY FORD HEALTH GENESYS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF PROVIDER AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CEBALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-874-6764
Mailing Address - Street 1:420 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1803
Mailing Address - Country:US
Mailing Address - Phone:810-232-3522
Mailing Address - Fax:810-762-4526
Practice Address - Street 1:420 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502
Practice Address - Country:US
Practice Address - Phone:810-232-3522
Practice Address - Fax:810-762-4526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty