Grunwald, Mark A
Grunwald, Mark A is an individual health care provider with primary practice located at 304 S Jackson St , Prairie Du Chien WI 53821-1821. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Grunwald, Mark A can be contacted via phone (608) 326-5459.Contact Information
Primary practice address
304 S Jackson St
Prairie Du Chien WI 53821-1821
Phone: (608) 326-5459
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 23439 | Wisconsin |
Profile Details
NPI number | 1336144914 |
---|---|
LBN Legal business name | Grunwald, Mark A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 20th, 2005 |
Last updated | Apr 9th, 2008 - about 17 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 | 1336144914 | NPPES |
Wisconsin | MEDICAID | 30483400 |
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