Great Lakes Interventional Pain Management,Pllc
LBN: Great Lakes Interventional Pain Management,Pllc
Great Lakes Interventional Pain Management,Pllc is an health care organization with primary practice located at 1311 S Linden Rd Suite A, Flint MI 48532-3428. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty.
Great Lakes Interventional Pain Management,Pllc can be contacted via phone (810) 230-1210, or through Reddy, Kavitha Rukkannagari via phone (810) 410-5148.
Contact Information
Primary practice address
1311 S Linden Rd Suite A
Flint MI 48532-3428
Phone: (810) 230-1210
Fax: (810) 230-1225
Website:
Authorized official contact:
Name: Reddy, Kavitha Rukkannagari Doctor of Medicine (MD)
Phone: (810) 410-5148
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 4301085040 | Michigan |
Profile Details
| NPI number | 1629447719 |
|---|---|
| LBN Legal business name | Great Lakes Interventional Pain Management,Pllc |
| DBA Doing business as | |
| Authorized official | Reddy, Kavitha Rukkannagari Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 18th, 2015 |
| Last updated | Nov 17th, 2016 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629447719 | NPPES |
| Michigan | Other | 1174515084 | NPI |
| Michigan | MEDICAID | 5353030 | NPI |
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