Organization
PROMED PREFERRED WI SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEV GRINMAN MD (OWNER)
(615) 499-3165
Entity
Organization
Contact information
Practice address
155 2ND ST S, HUDSON, WI 54016-2234
(615) 499-3165
Mailing address
329 S OYSTER BAY RD STE 2059, PLAINVIEW, NY 11803-3301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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