Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spectrum Health Primary Care Partners

Organization Pediatric Dermatology Physician · NPI 1215416961

Spectrum Health Primary Care Partners is a Pediatric Dermatology Physician in Owosso, Michigan. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
4

Practice location Address checks out

802 W King St
Owosso, MI 48867-2100
Phone: (517) 484-0004
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Cardiology Physician (primary) Taxonomy 2080P0202X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Pediatric Orthopaedic Surgery Physician Taxonomy 207XP3100X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1215416961
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSpectrum Health Primary Care Partners
Authorized official Elisabeth Lacey — Manager · (616) 486-6630
Other names Corewell Health Medical Group West; Spectrum Health Medical Group; Spectrum Health Medical Group
NPI enumeratedAugust 13, 2018
Last updated in NPPESOctober 31, 2023
Certification dateOctober 31, 2023
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560