Organization
SPARROW IONIA HOSPITAL
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Ionia General Surgery, SPARROW IONIA HOSPITAL GENERAL SURGERY
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) 523-1494
(616) 523-1496
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-6253
(517) 364-6204
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301038199
MI
208600000X
Surgery Physician
4301076427
MI
208600000X
Surgery Physician
Primary
5101014682
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C410380
BCBS MI
MI
05
—
1891879029
—
MI
Enumeration date
10/24/2006
Last updated
03/11/2024
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