Healthcare Provider Details

I. General information

NPI: 1568876910
Provider Name (Legal Business Name): SPARROW HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 06/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

V. Phone/Fax

Practice location:
  • Phone: 517-432-9277
  • Fax:
Mailing address:
  • Phone: 517-432-9277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301105041
License Number StateMI

VIII. Authorized Official

Name: ANITA PARKHURST
Title or Position: RESIDENCY COORDINATOR
Credential:
Phone: 517-432-9277