| NPI | 1861912537 |
|---|---|
| Doing Business As | SPECTRUM HEALTH MEDICAL GROUP FAMILY MEDICINE - CALEDONIA |
| Doing Business As | COREWELL HEALTH MEDICAL GROUP WEST |
| Entity Type | Organization |
| Authorized Contact | DAVID OTTENBAKER Associate Chief Medical Officer R 616-486-6686 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-10-31 |