Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Children's Center, Sparrow Regional Children's Center
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) 364-5490
(517) 364-5499
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-5490
(517) 364-5499
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0210X
Pediatric Nephrology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700C311000
BCBS GROUP NUMBER
MI
Enumeration date
06/07/2006
Last updated
03/27/2024
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