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Organization
SPECTRUM HEALTH HOSPITAL
Active
Organization
SPECTRUM HEALTH HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH LACEY (CREDENTIALING MANAGER)
(616) 486-6630
Entity
Organization
Contact information
Practice address
705 S GREENVILLE WEST DR STE 202, GREENVILLE, MI 48838-3530
(616) 267-9823
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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