Grune, Martin Theodore

Grune, Martin Theodore is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Grune, Martin Theodore can be contacted via phone (218) 786-8364.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Phone: (218) 786-8364
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 39996 Minnesota

Profile Details

NPI number 1760411565
LBN Legal business name Grune, Martin Theodore
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2006
Last updated May 10th, 2011 - about 13 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 1760411565 NPPES
Wisconsin MEDICAID 32329100
Wisconsin MEDICAID 116723500

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