Individual
MICHAEL J GRUESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4266
(262) 787-4026
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
42867
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050082935
RAIL ROAD MEDICARE
—
05
—
34105400
—
WI
Enumeration date
09/15/2006
Last updated
12/31/2021
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