Individual
DR. KENNETH JOHN GRAMYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
(208) 302-5155
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(083) 675-1702
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M6718
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003704700
—
ID
Enumeration date
08/14/2006
Last updated
04/04/2025
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