Organization
MICHIGAN PAIN CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK LOUIS GOSTINE MD (PRESIDENT)
(616) 285-1377
Entity
Organization
Contact information
Practice address
2060 EAST PARIS AVE SE, SUITE 200, GRAND RAPIDS, MI 49546
(616) 285-1377
(616) 285-1006
Mailing address
5555 GLENWOOD HILLS PKWY SE STE 2, GRAND RAPIDS, MI 49512-2091
(616) 940-2662
(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
—
700D160000
BLUE CROSS BLUE SHIELD
MI
Enumeration date
04/26/2006
Last updated
03/30/2021
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