Organization
SOUTHERN MICHIGAN PAIN CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KUIPER DO (PRESIDENT)
(269) 329-2887
Entity
Organization
Contact information
Practice address
3770 GLENKERRY CT, PORTAGE, MI 49024-0700
(269) 329-2887
(269) 329-2805
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
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050D111320
BCBSM
MI
Enumeration date
05/11/2006
Last updated
03/30/2021
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