| Botsford General Hospital | |
|
28100 Grand River Ave Ste 206 Farmington Hills MI 48336-5969 | |
| (947) 521-2710 | |
| (248) 888-2712 |
| Full Name | Botsford General Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 28100 Grand River Ave Ste 206, Farmington Hills, Michigan |
| Authorized Official Name and Position | Lesley Willbrandt (DIRECTOR SHARED SERVICES) |
| Authorized Official Contact | 9475221911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Botsford General Hospital 26901 Beaumont Blvd Southfield MI 48033-3849 Ph: () - | Botsford General Hospital 28100 Grand River Ave Ste 206 Farmington Hills MI 48336-5969 Ph: (947) 521-2710 |
| NPI Number | 1538103395 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 08/21/2019 |
| Medicare PECOS PAC ID | 2668385238 |
|---|---|
| Medicare Enrollment ID | O20031112000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538103395 | NPI | - | NPPES |
| 110H299920 | Other | MI | BLUE CROSS |
| G4730F | Other | MI | BLUE CARE NETWORK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Andrew Cykiert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629011572 PECOS PAC ID: 7719921071 Enrollment ID: I20050616001120 |
| Provider Name | Matteo Valenti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912991894 PECOS PAC ID: 5597772871 Enrollment ID: I20060310000423 |
| Provider Name | Benjamin Michael Rossi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609818582 PECOS PAC ID: 2163435223 Enrollment ID: I20060714000021 |
| Provider Name | Eugene W Laveroni |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285621474 PECOS PAC ID: 6305934670 Enrollment ID: I20071120000388 |
| Provider Name | Annette T Carron |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1306805866 PECOS PAC ID: 0244306850 Enrollment ID: I20080905000261 |
| Provider Name | David A Crowl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205044252 PECOS PAC ID: 0840337648 Enrollment ID: I20091028000092 |
| Provider Name | Kevin I Frankel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730159294 PECOS PAC ID: 2466595475 Enrollment ID: I20100129000399 |
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