Organization · Type 2 NPI

Sparrow Clinton Hospital

Plastic and Reconstructive Surgery Physician · St. Johns, MI

NPI number 1922735539 Active

Practice location

805 S Oakland St Fl 3
St. Johns, MI 48879-2253

Call (517) 253-6320 Map

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081

Specialties and licenses

Taxonomy	Code	License
Plastic Surgery Physician	208200000X	None listed
Surgery Physician	208600000X	None listed
Plastic and Reconstructive Surgery Physician Primary	2086S0122X	None listed

Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.

Another provider at this address

Sparrow Clinton HospitalInternal Medicine Physician St. Johns, MI NPI 1538752662

NPI record

NPI: 1922735539
Entity type: Organization (Type 2)
Issued: Aug 3, 2022
Last updated: Mar 11, 2024
Status: Active
Subpart: Yes of Sparrow Health System

Other names

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University of Michigan Health-Sparrow Clinton Plastic Surgery · doing business as

Authorized official

Misty Gunter Russian
Supervisor, Provider Enrollment
(517) 253-6308

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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 1922735539

Sparrow Clinton Hospital's National Provider Identifier is 1922735539, issued on Aug 3, 2022. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in St. Johns, MI. The record was last updated on Mar 11, 2024.