Organization · Type 2 NPI

Spectrum Health Primary Care Partners

Pediatric Orthopaedic Surgery Physician · Traverse City, MI

NPI number 1477853075 Active

Practice location

550 Munson Ave
Traverse City, MI 49686-3580

Call (616) 391-9814 Map

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Pediatric Orthopaedic Surgery Physician Primary	207XP3100X	None listed

Pediatric Orthopaedic Surgery Physician: An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

92 other providers at this address

Other pediatric orthopaedic surgery physician providers in Traverse City

Spectrum Health Primary Care PartnersPediatric Orthopaedic Surgery Physician Traverse City, MI NPI 1649680224

See all in Traverse City →

NPI record

NPI: 1477853075
Entity type: Organization (Type 2)
Issued: Oct 28, 2010
Last updated: Oct 31, 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 Krywanski
SVP, Finance
(616) 486-2253

Verify this record

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 1477853075

Spectrum Health Primary Care Partners's National Provider Identifier is 1477853075, issued on Oct 28, 2010. The primary taxonomy on file is Pediatric Orthopaedic Surgery Physician (207XP3100X), and the practice location is in Traverse City, MI. The record was last updated on Oct 31, 2023.