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Individual

DR. GARY L GRAMMENS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
701 25TH AVE S, SUITE # 505, MINNEAPOLIS, MN 55454-1513
(612) 455-2050
(612) 455-2009
Mailing address
9324 WYOMING AVE S, BLOOMINGTON, MN 55438-1436
(952) 944-1745

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
22088
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2042086
MEDICAL ASSISTANCE
MN
Enumeration date
02/10/2006
Last updated
07/08/2007
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