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General NPI Number Information
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NPI Number | 1720034481
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Entity Type | Organization
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Legal Business Name | EDWARD W. SPARROW HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 1200 E MICHIGAN AVE SUITE 345
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City | LANSING
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State | MI
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Zip | 48912-1800
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Country | US
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Telephone | 517-364-5610
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Fax | 517-364-5614
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Provider Business Mailing Address
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Address Line | PO BOX 13008
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City | LANSING
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State | MI
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Zip | 48901-3008
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Country | US
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Telephone | 517-364-5610
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Fax | 517-364-5614
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Authorized Official
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Title or Position | DIRECTOR PROFESSIONAL BILLING
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Name | MRS. DIANE S GALLUPS
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Credential |
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Telephone | 517-364-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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