ST JOHN PROVIDENCE EASTWOOD CLINIC
NPI 1558619510
Clinic/Center in Detroit, MI

Q: What is St John Providence Eastwood Clinic's NPI number?

The NPI number for St John Providence Eastwood Clinic is 1558619510. It was assigned to this organization in the NPPES registry on August 23, 2012.

Q: What is St John Providence Eastwood Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since August 23, 2012

4777 E OUTER DR STE 1105, DETROIT, MI 48234(313) 369-5508 Get Directions Write a Review

NPPES record last updated: August 23, 2012. Verified against the NPPES registry weekly; last sync: October 04, 2026.

On this page

About St John Providence Eastwood Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JOHN PROVIDENCE EASTWOOD CLINIC (NPI 1558619510) is a healthcare organization registered as a clinic/center in Detroit, Michigan and active in the NPI registry since August 2012. The organization lists Donald Healy, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1558619510

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameST JOHN PROVIDENCE EASTWOOD CLINIC

Location Address4777 E OUTER DR STE 1105Detroit, MI 48234-3241

Mailing Address4777 E Outer Dr Ste 1105Detroit, MI 48234-3241

Phone(313) 369-5508

Organization SubpartNo

Authorized OfficialDonald HealySupervisor · (313) 369-5508

Enumeration DateAugust 23, 2012

✔ NPI 1558619510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

4777 E OUTER DR STE 1105, Detroit, MI 48234

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St John Providence Eastwood Clinic's NPI number?

The NPI number for St John Providence Eastwood Clinic is 1558619510. It was assigned to this organization in the NPPES registry on August 23, 2012.

Where is St John Providence Eastwood Clinic located?

St John Providence Eastwood Clinic is located at 4777 E Outer Dr Ste 1105, Detroit, MI 48234. The listed phone number is (313) 369-5508.

What is St John Providence Eastwood Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for St John Providence Eastwood Clinic was last updated on August 23, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.