Organization · Type 2 NPI

Spectrum Health Primary Care Partners

Vascular Surgery Physician · Holland, MI

NPI number 1558776286 Active

Practice location

602 Michigan Ave
Holland, MI 49423-4918

Call (616) 267-8700 Map

Mailing address

100 Michigan St NE, MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

Taxonomy	Code	License
Internal Medicine Physician	207R00000X	None listed
Vascular Surgery Physician Primary	2086S0129X	None listed
Physician Assistant	363A00000X	None listed
Nurse Practitioner	363L00000X	None listed

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

159 other providers at this address

NPI record

NPI: 1558776286
Entity type: Organization (Type 2)
Issued: Jun 20, 2014
Last updated: Oct 31, 2023
Status: Active

Other names

<unavail>
Corewell Health Medical Group West · doing business as
Spectrum Health Medical Group · doing business as
Spectrum Health Medical Group · 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.

Is this your record? How to update it.

About NPI 1558776286

Spectrum Health Primary Care Partners's National Provider Identifier is 1558776286, issued on Jun 20, 2014. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Holland, MI. The record was last updated on Oct 31, 2023.