Organization
SPARROW IONIA HOSPITAL
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Portland Primary Care, SMG PORTLAND
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
9751 E GRAND RIVER AVE, PORTLAND, MI 48875-9774
(517) 647-6722
(517) 647-6838
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(616) 523-1400
(616) 523-1429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
238631
MI
Other
Enumeration date
11/24/2006
Last updated
03/11/2024
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