Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
SRCC Pediatric Hospitalist, UNIVERSITY OF MICHIGAN HEALTH-SPARROW PEDIATRIC HOSPITALISTS
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
1200 E MICHIGAN AVE, SUITE 460, LANSING, MI 48912-1800
(517) 364-2097
(517) 364-2077
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-2097
(517) 364-2077
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350C313590
BCBS GROUP NUMBER
MI
Enumeration date
05/25/2006
Last updated
03/27/2024
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