OrganizationActive
Spectrum Health Primary Care Partners
NPI 1477853075 · Pediatric Orthopaedic Surgery Physician · Traverse City, MI
Provider details
- NPI number
- 1477853075
- Entity type
- Organization
- Primary specialty
- Pediatric Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Spectrum Health Primary Care Partners
- Organization subpart
- Yes
- Authorized official
- Pauline Krywanski, Svp, Finance(616) 486-2253
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
550 Munson Ave
Traverse City, MI 49686-3580
Phone: (616) 391-9814
Approximate (ZIP-level) locationGet directions
Mailing address
100 Michigan St Ne
Grand Rapids, MI 49503-2560
Other names (DBA / former)
- Doing business as
- Corewell Health Medical Group West
Registry dates
- Enumerated
- 2010-10-28
- Last updated
- 2023-10-31
- Certified
- 2023-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.