MEDICARE: WEST MICHIGAN PAIN CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1447973060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST MICHIGAN PAIN CENTER PC

Provider Business Mailing Address
First Line	:	4024 PARK EAST CT SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-8810
Country	:	US
Telephone Number	:	616-727-0083
Fax Number	:	866-493-3535

Provider Business Practice Location Address
First Line	:	4024 PARK EAST CT SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-8810
Country	:	US
Telephone Number	:	616-727-0083
Fax Number	:	866-493-3535

Authorized Official
Title or Position	:	OWNER
Name	:	GIRISH JUNEJA
Credential	:	MD
Telephone Number	:	616-460-3164

Provider Enumeration Date	:	09/20/2022
Last Update Date	:	11/14/2025

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