Individual
DR. GREGORY GRUNWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2380 W MAIN ST STE A, MEDFORD, OR 97501-2390
(541) 858-7183
Mailing address
2380 W MAIN ST STE A, MEDFORD, OR 97501-2390
(541) 858-7183
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO22277
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138021
—
OR
01
—
838334020
BCBS-ROSEBURG
OR
01
—
838366007
BCBS-MCMINNVILLE
OR
01
—
844477024
BCBS-GRANTS PASS
OR
01
—
858463018
BCBS-MEDFORD
OR
01
—
858464016
BCBS-SPRINGFIELD
OR
01
—
P00285793
RR MEDICARE
OR
Enumeration date
03/28/2006
Last updated
09/23/2010
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