# 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:** 1699084871
- **Legal business name:** SPECTRUM HEALTH PRIMARY CARE PARTNERS
- **Authorized official:** PAULINE KRYWANSKI (CFO)
- **Authorized official phone:** (616) 486-2253

## Contact information

- **Practice address:** 4069 LAKE DR SE, GRAND RAPIDS, MI 49546-8816
- **Practice address phone:** (616) 486-2860
- **Mailing address:** 100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2010
- **Last updated:** 10/31/2023