Individual
DR. GRANT GERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
539 HARKLE RD, SUITE B, SANTA FE, NM 87505-4782
(505) 795-7735
(505) 795-7732
Mailing address
539 HARKLE RD, SUITE B, SANTA FE, NM 87505-4782
(505) 795-7735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
90-196
NM
208D00000X
General Practice Physician
Primary
90-196
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30154
LOVELACE
NM
05
—
F9204
—
NM
Enumeration date
12/01/2006
Last updated
07/19/2022
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