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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