Organization
GRAND VALLEY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA M DUNWOODY (QUALITY AND OPERATIONS MGR)
(616) 224-1110
Entity
Organization
Contact information
Practice address
2680 LEONARD ST NE, STE 1, GRAND RAPIDS, MI 49525-6902
(616) 224-1110
Mailing address
2680 LEONARD ST NE STE 1, GRAND RAPIDS, MI 49525-6902
(616) 224-1110
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
416829
MI
261QM1300X
Multi-Specialty Clinic/Center
Primary
416829
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40362
BCBS
MI
01
—
490004173
MEDICARE RAILROAD
MI
01
—
OD17003
BCBS SECONDARY
MI
Enumeration date
05/24/2005
Last updated
01/26/2026
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