Individual
RICHARD J GRUNDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 S PARK ST, ST MARYS HOSPITAL DEAN MEDICAL CENTER, MADISON, WI 53715-1849
(608) 258-6975
(608) 258-5222
Mailing address
700 S PARK ST, ST MARYS HOSPITAL DEAN MEDICAL CENTER, MADISON, WI 53715-1849
(608) 258-6975
(608) 258-5222
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
268-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275599235
—
WI
Enumeration date
04/26/2006
Last updated
12/18/2020
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