Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
Sparrow Medical Group Okemos, University of Michigan Health-Sparrow Primary Care, University of Michigan Health-Sparrow Okemos Grand River Primary 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
1600 W GRAND RIVER AVE, SUITE 4, OKEMOS, MI 48864-2394
(517) 381-6880
(517) 381-6881
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 381-6880
(517) 381-6881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080C311250
BCBS GROUP NUMBER
MI
Enumeration date
05/19/2006
Last updated
03/27/2024
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