Organization
SPARROW IONIA HOSPITAL
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Ionia, SPARROW IONIA HOSPITAL PHYSICIANS
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
3565 S STATE RD, IONIA, MI 48846-9416
(616) 523-1400
(616) 523-1429
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-6253
(517) 364-6204
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
JP038199
MI
208600000X
Surgery Physician
AJ076427
MI
208600000X
Surgery Physician
RH014682
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588747075
—
MI
01
—
700C46006
BCBS OF MI
MI
Enumeration date
10/20/2006
Last updated
03/11/2024
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