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Organization
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Active
Organization
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Active
Other names
Corewell Health Medical Group West
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH LACEY (CREDENTIALING MANAGER)
(616) 486-6630
Entity
Organization
Contact information
Practice address
6170 VALLEY LANE DR SE, KENTWOOD, MI 49508-6658
(616) 754-6185
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/24/2021
Last updated
10/31/2023
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