# SPECTRUM HEALTH PRIMARY CARE PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPECTRUM HEALTH PRIMARY CARE PARTNERS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174835102
- **Legal business name:** SPECTRUM HEALTH PRIMARY CARE PARTNERS
- **Authorized official:** PAULINE KRYWANSKI (CFO)
- **Authorized official phone:** (616) 486-2253

## Contact information

- **Practice address:** 4085 BURTON ST SE, SUITE 312, GRAND RAPIDS, MI 49546-2444
- **Practice address phone:** (616) 284-8842
- **Mailing address:** 100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0102X | Surgical Critical Care Physician | — | NULL | — |
| 2086S0102X | Surgical Critical Care Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2010
- **Last updated:** 07/07/2010