Organization · Type 2 NPI

Spectrum Health Primary Care Partners

Clinical Medical Laboratory · Grand Rapids, MI

NPI number 1407156052 Active

Practice location

1040 Monroe Ave NW
Grand Rapids, MI 49503

Call (616) 284-8805 Map

Mailing address

100 Michigan St NE, Mc 845
Grand Rapids, MI 49503-2560

Specialties and licenses

Taxonomy	Code	License
Cardiovascular Disease Physician	207RC0000X	None listed
Clinical Medical Laboratory Primary	291U00000X	None listed

Clinical Medical Laboratory: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to det…

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NPI record

NPI: 1407156052
Entity type: Organization (Type 2)
Issued: Oct 29, 2010
Last updated: Oct 27, 2023
Status: Active
Subpart: Yes of Spectrum Health Primary Care Partners

Other names

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Corewell Health Medical Group West · doing business as

Authorized official

Pauline Krywanksi
SVP Finance
(616) 486-2253

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407156052

Spectrum Health Primary Care Partners's National Provider Identifier is 1407156052, issued on Oct 29, 2010. The primary taxonomy on file is Clinical Medical Laboratory (291U00000X), and the practice location is in Grand Rapids, MI. The record was last updated on Oct 27, 2023.