Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Great Lakes Neurosurgical Associates, PC

Organization Neurological Surgery Physician · NPI 1366590929

Great Lakes Neurosurgical Associates, PC provides Neurological Surgery Physician services in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone: (616) 454-3465
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence LH029420 (MI)

Record details

NPI number1366590929
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Santos — Executive Director · (616) 242-7042
NPI enumeratedJanuary 8, 2007
Last updated in NPPESOctober 24, 2023
Certification dateOctober 24, 2023
Mailing address3350 Eagle Park Dr Ne Ste 102, Grand Rapids, MI 49525-4570

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