Individual
DR. CHARLES GRUENWALD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4309 BLUEBONNET BLVD, BATON ROUGE, LA 70809
(225) 925-3140
(225) 223-6010
Mailing address
4309 BLUEBONNET BLVD, BATON ROUGE, LA 70809
(225) 925-3140
(225) 223-6010
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
04294R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1188506
—
LA
01
—
13-00043
UNITED
LA
01
—
690256
AETNA
LA
Enumeration date
06/13/2005
Last updated
03/01/2011
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