# SPECTRUM HEALTH PRIMARY CARE PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPECTRUM HEALTH PRIMARY CARE PARTNERS
- **Other names:** Corewell Health Medical Group West
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336422948
- **Legal business name:** SPECTRUM HEALTH PRIMARY CARE PARTNERS
- **Authorized official:** LESLIE FLAKE (SVP FINANCE)
- **Authorized official phone:** (616) 391-2525

## Contact information

- **Practice address:** 75 SHELDON AVE SE, GRAND RAPIDS, MI 49503-4224
- **Practice address phone:** (616) 391-6120
- **Mailing address:** 100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | — | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |

## Other

- **Enumeration date:** 09/21/2011
- **Last updated:** 10/31/2023