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

Spectrum Health Primary Care Partners

Organization Allergy & Immunology Physician · NPI 1699084871

Spectrum Health Primary Care Partners is an Allergy & Immunology Physician in Grand Rapids, Michigan. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
10
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4069 Lake Dr SE
Grand Rapids, MI 49546-8816
Phone: (616) 486-2860
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X
Allergy & Immunology Physician Taxonomy 207K00000X
Internal Medicine Physician Taxonomy 207R00000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Ophthalmology Physician Taxonomy 207W00000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Otolaryngology Physician Taxonomy 207Y00000X
Pediatrics Physician Taxonomy 208000000X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Surgery Physician Taxonomy 208600000X

Record details

NPI number1699084871
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSpectrum Health Primary Care Partners
Authorized official Pauline Krywanski — Cfo · (616) 486-2253
Other names Corewell Health Medical Group West
NPI enumeratedOctober 5, 2010
Last updated in NPPESOctober 31, 2023
Certification dateOctober 31, 2023
Mailing address100 Michigan St Ne, Mc845, Grand Rapids, MI 49503-2560

Other providers in Grand Rapids