Individual
GARY M GROLEMUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10 PROFESSIONAL DR, BRUNSWICK, GA 31520-3774
(912) 264-6150
(912) 264-5712
Mailing address
10 PROFESSIONAL DR, BRUNSWICK, GA 31520-3774
(912) 264-6150
(912) 264-5712
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000543
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000322033A
—
GA
05
—
000322033B
—
GA
Enumeration date
07/30/2006
Last updated
06/24/2014
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