Provider Demographics
NPI:1962588699
Name:HENRY FORD HOSPITAL
Entity type:Organization
Organization Name:HENRY FORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CANCER CENTER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-916-1332
Mailing Address - Street 1:4261 WESTPHAL ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-3947
Mailing Address - Country:US
Mailing Address - Phone:734-676-7221
Mailing Address - Fax:
Practice Address - Street 1:19675 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1021
Practice Address - Country:US
Practice Address - Phone:734-479-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195321284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI500N13980Medicare ID - Type Unspecified
MIP44877Medicare UPIN