Organization
SPARROW CARSON HOSPITAL
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
Sparrow Medical Group Pain Management Carson City, University of Michigan Health-Sparrow, University of Michigan Health-Sparrow Carson Pain Management
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
406 E ELM ST, CARSON CITY, MI 48811-9693
(989) 584-3971
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(989) 584-3971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050E910250
BCBS ANESTHESIOLOGISTS
MI
01
—
368419900
USDOL
MI
01
—
430E910280
BCBS CRNAS
MI
Enumeration date
06/15/2006
Last updated
04/05/2024
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