OrganizationActive
Spectrum Health Primary Care Partners
NPI 1740810563 · Preventive Medicine/Occupational Environmental Medicine Physician · Grand Rapids, MI
Provider details
- NPI number
- 1740810563
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Spectrum Health Primary Care Partners
- Organization subpart
- Yes
- Authorized official
- Elisabeth Lacey, Manager(616) 486-6630
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
435 Ionia Ave Sw
Grand Rapids, MI 49503-5161
Phone: (616) 486-6790
Approximate (ZIP-level) locationGet directions
Mailing address
100 Michigan St Ne # Mc845
Grand Rapids, MI 49503-2560
Other names (DBA / former)
- Doing business as
- Corewell Health Medical Group West
- Doing business as
- Spectrum Health Medical Group
Registry dates
- Enumerated
- 2020-01-21
- 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.