Provider Demographics
NPI: | 1649540642 |
---|---|
Name: | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
Entity type: | Organization |
Organization Name: | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR FINANCIAL PLANNING |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ADRIANNE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BRYAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 616-643-9123 |
Mailing Address - Street 1: | 100 MICHIGAN ST NE |
Mailing Address - Street 2: | MC 845 |
Mailing Address - City: | GRAND RAPIDS |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49503-2560 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 588 E LAKEWOOD BLVD |
Practice Address - Street 2: | |
Practice Address - City: | HOLLAND |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49424-2023 |
Practice Address - Country: | US |
Practice Address - Phone: | 616-395-9000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-01-06 |
Last Update Date: | 2023-10-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | Group - Multi-Specialty |
No | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
No | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | Group - Multi-Specialty |