Grudem, Charles Michael
Grudem, Charles Michael is an sole proprietor health care provider with primary practice located at 3200 Sw 34Th Ave Suite 502, Ocala FL 34474-7456. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Grudem, Charles Michael can be contacted via phone (352) 629-7011.Contact Information
Primary practice address
3200 Sw 34Th Ave Suite 502
Ocala FL 34474-7456
Phone: (352) 629-7011
Fax: (352) 629-7924
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | ME 61060 | Florida |
Profile Details
| NPI number | 1093825150 |
|---|---|
| LBN Legal business name | Grudem, Charles Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jun 27th, 2008 - about 16 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 | 1093825150 | NPPES |
| Other | 17875 | BCBS | |
| Other | 720000084 | BCBS |
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