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NPI Code Detail

MEDICARE: SPECTRUM HEALTH PRIMARY CARE PARTNERS

MEDICARE: SPECTRUM HEALTH PRIMARY CARE PARTNERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician
2207RP1001XPulmonary Disease Physician

General Provider Information

NPI Number : 1013219351
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECTRUM HEALTH PRIMARY CARE PARTNERS
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE
Second Line : MC 845
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N MAIN ST
Second Line :
City : SHERIDAN
State : MI
Zip : 48884-9235
Country : US
Telephone Number : 616-949-8244
Fax Number :
Authorized Official
Title or Position : SVP
Name : PAULINE KRYWANSKI
Credential :
Telephone Number : 616-486-2253
Provider Enumeration Date : 11/18/2010
Last Update Date : 10/30/2023

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Directions to “SPECTRUM HEALTH PRIMARY CARE PARTNERS ” Practice Location

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