Grundmeyer, Wayne Alvin

Grundmeyer, Wayne Alvin is an sole proprietor health care provider with primary practice located at 120 Meadowcrest St #220, Gretna LA 70056-5255. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Grundmeyer, Wayne Alvin can be contacted via phone (504) 391-7595.

Contact Information

Primary practice address
120 Meadowcrest St #220 Gretna LA 70056-5255
Fax: (504) 391-7599
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD 014877 Louisiana

Profile Details

NPI number 1801903042
LBN Legal business name Grundmeyer, Wayne Alvin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Jul 8th, 2007 - about 19 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 1801903042 NPPES
Louisiana MEDICAID 1324299

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