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Organization

FLINT NEUROSCIENCE CENTER, PLLC

Active
Parent organization
FLINT NEUROSCIENCE CENTER, PLLC
Other names
Great Lakes Spine Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
FLINT NEUROSCIENCE CENTER, PLLC
Authorized official
DR. HUGO LOPEZ-NEGRETE MD (MANAGING PARTNER)
(810) 733-7560
Entity
Organization

Contact information

Practice address
G3239 BEECHER RD, FLINT, MI 48532-3616
(810) 733-7560
(810) 733-2890
Mailing address
DEPT. CH 17809, PALATINE, IL 60055-7809
(810) 733-7560
(810) 733-2890

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
700B511200
BCBS OF MICHIGAN
01
C14627
MEDICARE RAILROAD
Enumeration date
05/14/2008
Last updated
08/14/2013
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