Individual
ANDREW ROBERT GRUDZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7500 SMOKE RANCH RD STE 200, LAS VEGAS, NV 89128-0373
(702) 233-0727
(702) 233-4799
Mailing address
7150 W SUNSET RD STE 201A, LAS VEGAS, NV 89113-1981
(702) 902-1939
(702) 442-1886
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20748
NV
208800000X
Urology Physician
21055
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000206911
UNISON HEALTH PLAN
SC
01
—
2280313
CIGNA MEDICARE
NC
01
—
5580793
AETNA
SC
05
—
5907458
—
NC
01
—
771828
WELLCARE
SC
01
—
790598L
EDS
NC
01
—
80023030
SELECT HEALTH
SC
01
—
8522204
CIGNA
SC
05
—
GP1521
—
SC
05
—
GP4522
—
SC
01
—
P00360558
RAILROAD MEDICARE
SC
05
—
T50860
—
SC
Enumeration date
03/08/2006
Last updated
02/02/2021
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