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RODNEY E GROLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1550 S PIONEER WAY, SUITE 370, MOSES LAKE, WA 98837-4613
(410) 218-8059
Mailing address
1550 S PIONEER WAY, SUITE 370, MOSES LAKE, WA 98837-4613
(410) 218-8059

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
C53617
CA
208600000X
Surgery Physician
Primary
MD60050963
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1334455
AETNA HMO
MD
01
145724700
FEDERAL WORKMAN'S COMP
MD
05
402277700
MD
01
7843490
AETNA PPO
MD
01
887BAA62011004
CAREFIRST
MD
01
K5850005
CAREFIRST DC
DC
01
P00354284
RR MEDICARE
MD
Enumeration date
10/18/2005
Last updated
08/06/2013
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