Individual
DR. CHARLES J GRUICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2356 PASS RD, SUITE 100, BILOXI, MS 39531-2236
(228) 388-7080
(228) 388-7493
Mailing address
2356 PASS RD, SUITE 100, BILOXI, MS 39531-2236
(228) 388-7080
(228) 388-7493
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
08349
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08349
LIC.#
MS
Enumeration date
10/26/2006
Last updated
03/07/2023
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