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Individual

ROBERT J GROENEWOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R026334 - 0461
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0006659
SD BLUE CROSS
SD
01
051K0GR
MN BLUE CROSS
MN
05
0573980
IA
05
460224743-48
NE
01
460224743-57105-AC41
TRICARE PROVIDER #
SD
05
5753700
SD
01
R026334
DAKOTACARE PROVIDER #
SD
Enumeration date
08/11/2006
Last updated
03/06/2008
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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