GREAT LAKES INTERVENTIONAL PAIN MANAGEMENTPLLC NPI 1629447719

NPI Information

GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC is a pain medicine physical medicine rehabilitation in Flint, MI. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC NPI is 1629447719. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1311 S LINDEN RD
SUITE A
FLINT, MI
ZIP 48532-428
Phone: (810) 230-1210
Fax: (810) 230-1225

The provider's authorized official is Kavitha Rukkannagari Reddy .
The authorized official title is Physician and has the following contact phone number (810) 410-5148.

The CLIA number assigned to this NPI record is 23D2015468 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/18/2015 and was last updated on 11/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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