Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Neurosurgical Associates, PC

Organization Neurological Surgery Physician · NPI 1366590929

Great Lakes Neurosurgical Associates, PC is a Neurological Surgery Physician 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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