Organization
SPARROW CLINTON HOSPITAL
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Clinton Plastic 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
805 S OAKLAND ST FL 3, SAINT JOHNS, MI 48879-2253
(517) 253-6320
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 253-6320
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
03/11/2024
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