Provider Demographics
NPI:1275871832
Name:DETROIT MEDICAL CENTER SINAI GRACE HOSPITAL
Entity Type:Organization
Organization Name:DETROIT MEDICAL CENTER SINAI GRACE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMIO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGINS WOODHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-966-9538
Mailing Address - Street 1:6071 W OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2624
Mailing Address - Country:US
Mailing Address - Phone:313-966-9538
Mailing Address - Fax:
Practice Address - Street 1:3495 PINE ESTATES DRIVE
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323
Practice Address - Country:US
Practice Address - Phone:248-895-2218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010069282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital