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A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent Medicine |
207QA0000X | 08 | Physician/Family Practice | |
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker |
| NPI Number | 1841079787 |
| LBN Legal business name | SPARROW EATON HOSPITAL |
| Authorized official | MISTY RUSSIAN - (SUPERVISOR, PROVIDER ENROLLMENT) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 09/28/2023 |
| Last updated | 11/08/2024 - More than a year ago |
| Identifiers | n/a |
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SPARROW EATON HOSPITAL
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SPARROW EATON HOSPITAL