Individual
DR. DAVID A GRUNOW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 676-4102
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41208
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75459060
—
CO
Enumeration date
02/27/2006
Last updated
01/29/2021
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