Individual
STEPHEN H GRUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, CANCER CENTER, FARMINGTON, CT 06030-2875
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
042165
CT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
042165
CT
207RX0202X
Medical Oncology Physician
042165
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376520270
—
CT
Enumeration date
12/30/2005
Last updated
11/07/2012
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