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Spectrum Health Primary Care Partners

Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Belmont, MI

NPI 1811206006 · NPPES record last updated Oct 31, 2023

Key facts

NPI
1811206006
Entity type
Organization (NPI type 2)
Primary specialty
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice address
5761 Jupiter Ave NE
Belmont, MI 49306-8859
Phone
(616) 364-0120
NPI assigned
Oct 5, 2010
Organization subpart
Yes
Parent organization (as reported)
SPECTRUM HEALTH PRIMARY CARE PARTNERS

Authorized official

Name
Pauline Krywanski
Title
Cfo
Phone
(616) 486-2253

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Spectrum Health Partners (197 organizations share this tax ID)
Part of
Spectrum Health Partners

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0300X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

5761 Jupiter Ave NE
Belmont, MI 49306-8859

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560

Other names

  • Corewell Health Medical Group West Doing business as

Other providers in Belmont, MI

All providers in Belmont, MI · Geriatric Medicine (Internal Medicine) Physician in Michigan

Sources for this page

Verify at the official NPI Registry.