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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336144914 NPPES
Wisconsin MEDICAID 30483400

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