| Kevin Edward Fitzgerald, MD | |
| 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 | |
| (616) 285-1377 | |
| (616) 285-1006 | 
| Full Name | Kevin Edward Fitzgerald | 
|---|---|
| Gender | Male | 
| Speciality | Pain Medicine - Interventional Pain Medicine | 
| Location | 4100 Lake Dr Se, Grand Rapids, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144281080 | NPI | - | NPPES | 
| 4532350-10 | Medicaid | MI | |
| 5648777 | Other | CIGNA | |
| 4592438-10 | Medicaid | MI | |
| 23113 | Other | HEALTH PLAN OF MICHIGAN | |
| 4507437-10 | Medicaid | MI | |
| 550410072 | Other | MI | BLUE CROSS BLUE SHIELD | 
| P00057547 | Other | RAILROAD MEDICARE | |
| 7000144071 | Other | PRIORITY HEALTH | |
| 4642669 | Other | AETNA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 4301044533 (Michigan) | Primary | 
| Entity Name | Michigan Pain Consultants Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1467418574 PECOS PAC ID: 8426959099 Enrollment ID: O20040225001094 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kevin Edward Fitzgerald, MD 61 Commerce Ave Sw, Grand Rapids, MI 49503-4124 Ph: (616) 940-0660 | Kevin Edward Fitzgerald, MD 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 Ph: (616) 285-1377 | 
| Mary C Leemputte, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 1900 Wealthy St Se Ste 300, Grand Rapids, MI 49506 Phone: 616-774-8345 | |
| Fred Neal Davis, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546 Phone: 616-285-1377 Fax: 616-285-1154 | |
| Dr. Kevin M. Nemeth, M.D. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 2060 East Paris Ave Se Ste 200, Grand Rapids, MI 49546 Phone: 616-285-1377 Fax: 616-285-1154 | |
| Joseph Yared Vanden Bosch, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 Phone: 616-285-1377 Fax: 616-285-1006 | |
| Daniel James Veldheer, M.D. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 2060 E Paris Ave Se, Grand Rapids, MI 49546 Phone: 616-285-1377 | |
| Mark Louis Gostine, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546 Phone: 616-285-1377 Fax: 616-285-1006 |