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Contact Information

GREAT LAKES PAIN CONSULT PLLC
4121 SHRESTHA DR
BAY CITY, MI48706
 Phone: 989-686-6900
 Fax: 989-686-6911
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for GREAT LAKES PAIN CONSULT PLLC

NPI Number 1255370094
LBN Legal business name GREAT LAKES PAIN CONSULT PLLC
Authorized official THERON GROVER - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/06/2006
Last updated 06/19/2014 - About 12 years ago
Identifiers
MI Other 050Z901090 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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