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
Fax: (505) 998-1660
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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