Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Mason Primary Care, University of Michigan Health-Sparrow Primary Care, Sparrow Medical Group Mason
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
230 TEMPLE ST, MASON, MI 48854-1837
(517) 676-9066
(517) 676-3505
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 676-9066
(517) 676-3505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70-0-C3-0154-0
BCBS GROUP NUMBER
MI
Enumeration date
11/30/2007
Last updated
03/27/2024
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