Individual
DR. BRIAN GRONERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1234
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2001-200
NM
207LP2900X
Pain Medicine (Anesthesiology) Physician
2001-200
NM
207LP3000X
Pediatric Anesthesiology Physician
Primary
2001-200
NM
207LP3000X
Pediatric Anesthesiology Physician
ME69110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104477100
—
FL
05
—
1643587
—
TX
01
—
201029035
PHP, SALUD, ETC...
NM
01
—
264798
MARYLAND DEPT. OF LABOR
MD
05
—
579617
—
AZ
05
—
64907
—
NM
05
—
80729541
—
CO
05
—
B0966
—
NM
01
—
NM009G13
BLUE CROSS BLUE SHEILD
NM
Enumeration date
05/27/2005
Last updated
03/13/2025
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