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Organization

EDWARD W. SPARROW HOSPITAL ASSOCIATION

Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
Sparrow Medical Group Nursing Home Specialist, University of Michigan Health-Sparrow Nursing Home Specialists
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
2909 E GRAND RIVER AVE STE 102, LANSING, MI 48912-4335
(517) 364-8670
(517) 364-8671
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-8670
(517) 364-8671

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
Primary
207RG0300X
Geriatric Medicine (Internal Medicine) Physician

Other

Enumeration date
12/18/2019
Last updated
03/27/2024
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