Healthcare Provider Details

I. General information

NPI: 1902356140
Provider Name (Legal Business Name): MIDMICHIGAN PAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 HAWTHORN DR SUITE B
MT PLEASANT MI
48858-1202
US

IV. Provider business mailing address

2305 HAWTHORN DR SUITE B
MT PLEASANT MI
48858-1202
US

V. Phone/Fax

Practice location:
  • Phone: 989-317-8000
  • Fax: 989-317-8536
Mailing address:
  • Phone: 989-317-8000
  • Fax: 989-317-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TOLGA KURT
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 989-317-8000