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Individual
MARTIN THEODORE GRUNE
Active
Individual
MARTIN THEODORE GRUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
39996
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116723500
—
MN
05
—
32329100
—
WI
Enumeration date
07/02/2006
Last updated
05/10/2011
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