Gostine, Mark Louis

Gostine, Mark Louis is an individual health care provider with primary practice located at 2060 E Paris Ave Se Suite 200, Grand Rapids MI 49546-6113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Gostine, Mark Louis can be contacted via phone (616) 285-1377.

Contact Information

Primary practice address
2060 E Paris Ave Se Suite 200 Grand Rapids MI 49546-6113
Fax: (616) 285-1006
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 4301041353 Michigan

Profile Details

NPI number 1619938545
LBN Legal business name Gostine, Mark Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated May 4th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619938545 NPPES
Other 7000027071 PRIORITY HEALTH
Other 1070467 PRIORITY HEALTH
Other 550410415 PRIORITY HEALTH
Other 1492766 PRIORITY HEALTH
Other 40982 PRIORITY HEALTH
MEDICAID 4552951-10 PRIORITY HEALTH
Other 7000027071 PRIORITY HEALTH
MEDICAID 4654209-10 PRIORITY HEALTH

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