Individual
MARC OLAV GRANRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6900
(208) 625-6710
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6900
(208) 625-6910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29289
MN
207R00000X
Internal Medicine Physician
65851
MN
208M00000X
Hospitalist Physician
Primary
M-15879
ID
Other
Enumeration date
04/09/2018
Last updated
04/12/2024
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