Organization
GREAT LAKES PAIN CONSULT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERON HUGH GROVER MD (PRESIDENT)
(989) 686-6911
Entity
Organization
Contact information
Practice address
4121 SHRESTHA DR, BAY CITY, MI 48706
(989) 686-6900
(989) 686-6911
Mailing address
61 COMMERCE AVE SW, GRAND RAPIDS, MI 49503-4124
(616) 940-0660
(616) 940-1965
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050Z901090
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/06/2006
Last updated
06/19/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us