Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Primary Care, Sparrow Medical Group DeWitt, University of Michigan Health-Sparrow DeWitt Primary Care
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
13191 SCHAVEY RD, SUITE 3, DEWITT, MI 48820-9036
(517) 669-9109
(517) 669-9839
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 669-9109
(517) 669-9839
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080A910070
BCBS GROUP NUMBER
MI
Enumeration date
05/18/2006
Last updated
03/26/2024
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