Individual
LYNN MAKELA GRUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 LUDINGTON ST, ESCANABA, MI 49829
(906) 786-3311
Mailing address
3650 E MILLS RD, PICKFORD, MI 49774-9231
(480) 380-6950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301079343
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003820200
—
MI
05
—
4387722
—
MI
01
—
930117023
MEDICARE - MULT - RAILROAD
—
01
—
LG079343
BLUE SHIELD
MI
01
—
P00365745
MEDICARE - MULT - RAILROAD
—
Enumeration date
07/27/2006
Last updated
05/20/2008
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