Individual
ROYAL GENE GRUENEICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
277 STATE STREET, STE 2A, BANGOR, ME 04401-5440
(207) 990-2580
(207) 990-1930
Mailing address
277 STATE STREET, STE 2A, BANGOR, ME 04401-5440
(207) 990-2580
(207) 990-1930
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS993
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037935
ANTHEM
—
01
—
2336158
AETNA
—
Enumeration date
01/13/2006
Last updated
12/01/2010
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