Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ascension Providence Hosptial

Organization Family Medicine Physician · NPI 1053684647

Ascension Providence Hosptial provides Family Medicine Physician services in Brighton, Michigan. Licensed in Michigan. Registered with an NPI since 2012.

Licensed in
MI
In the registry since
2012
Specialties on file
4

Practice location Address checks out

10415 Grand River Rd 100
Brighton, MI 48116-6533
Phone: (810) 227-1020
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X (MI)
Obstetrics & Gynecology Physician Taxonomy 207V00000X (MI)

Record details

NPI number1053684647
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sarah Starkel — Credentialing Coordinator · (248) 680-8121
NPI enumeratedFebruary 14, 2012
Last updated in NPPESJune 28, 2022
Certification dateJune 28, 2022
Mailing address28000 Dequindre Rd, Warren, MI 48092-2468

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