Organization
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Active
Organization
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Active
Other names
Corewell Health Medical Group West
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH LACEY (CREDENTIALING MGR)
(616) 486-6630
Entity
Organization
Contact information
Practice address
749 PHILLIPS ST, SOUTH HAVEN, MI 49090-1842
(616) 494-8724
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
10/31/2023
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