Organization
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Active
Parent organization
SPECTRUM HEALTH HOSPITAL
Other names
SPECTRUM HEALTH MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECTRUM HEALTH HOSPITAL
Authorized official
JAMES TUCCI (PRESIDENT)
(616) 391-2062
Entity
Organization
Contact information
Practice address
4444 KALAMAZOO AVE SE, SUITE 104, GRAND RAPIDS, MI 49508-4600
(616) 391-3302
Mailing address
PO BOX 2864, GRAND RAPIDS, MI 49501-2864
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
4704173499
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
420D121610
BCBS GROUP 420D121610
MI
Enumeration date
03/18/2009
Last updated
12/14/2021
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