Grollman, Andrew
Grollman, Andrew is an individual health care provider with primary practice located at 610 Broadway Blvd Ne , Albuquerque NM 87102-2372. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Grollman, Andrew can be contacted via phone (505) 242-3991.Contact Information
Primary practice address
610 Broadway Blvd Ne
Albuquerque NM 87102-2372
Phone: (505) 242-3991
Fax: (505) 998-1660
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 25MA08386700 | New Jersey |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD2010-0319 | New Mexico |
| Other Service Providers / Specialist | 174400000X | MD2010-0319 | New Mexico |
Profile Details
| NPI number | 1811157100 |
|---|---|
| LBN Legal business name | Grollman, Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2008 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811157100 | NPPES |
| New Mexico | Other | MD2010-0319 | NM MEDICAL BOARD LICENSE |
| New Mexico | MEDICAID | 45558230 | NM MEDICAL BOARD LICENSE |
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