Individual
JORGE GRANJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, UMP SURGERY CLINIC, MINNEAPOLIS, MN 55455-0356
(612) 884-0649
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455-1623
(612) 884-0649
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33290
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8345228000
—
MN
Enumeration date
06/18/2006
Last updated
10/30/2012
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