Organization
SAINT MARY'S HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GUSHO (CFO, TREASURER)
(734) 398-0642
Entity
Organization
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 732-8956
Mailing address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/17/2006
Last updated
01/30/2023
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