Individual
GRISHMA P BHARUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
108917
MN
207W00000X
Ophthalmology Physician
Primary
60673
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
05/30/2012
Last updated
07/21/2022
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