Organization
GREAT LAKES PHYSIATRISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK S POLLINA MD (PRESIDENT)
(586) 498-2400
Entity
Organization
Contact information
Practice address
25311 LITTLE MACK AVE, SUITE B, ST CLAIR SHORES, MI 48081
(586) 498-2400
(586) 498-2800
Mailing address
8301 RELIABLE PKWY, CHICAGO, IL 60686-0083
(586) 498-2400
(586) 498-2800
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301045967
MI
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811096548
—
MI
Enumeration date
09/21/2006
Last updated
09/14/2020
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