Individual
DR. GREGORY ALLEN GRANRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 SMITH AVE N, SUITE 500, SAINT PAUL, MN 55102-2534
(651) 292-0616
(651) 726-7256
Mailing address
225 SMITH AVE N, SUITE 500, SAINT PAUL, MN 55102-2534
(651) 292-0616
(651) 726-7256
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
24998
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
24998
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30578300
—
WI
05
—
894270600
—
MN
Enumeration date
02/13/2006
Last updated
06/04/2020
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