Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
Sparrow Pediatric Intensivist, University of Michigan Health-Sparrow Pediatric Critical Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARROW HEALTH SYSTEM
Authorized official
MISTY GUNTER RUSSIAN (SUPERVISOR, PROVIDER ENROLLMENT)
(517) 253-6308
Entity
Organization
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-2117
(517) 364-3994
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-2117
(517) 364-3994
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Enumeration date
08/12/2010
Last updated
03/27/2024
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