Organization
ROSARIO GRAU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA DEL ROSARIO GRAU MD (SOLE MEMBER)
(612) 225-0176
Entity
Organization
Contact information
Practice address
6542 REGENCY LN, SUITE 205, EDEN PRAIRIE, MN 55344-7847
(612) 225-0176
(612) 808-6738
Mailing address
6542 REGENCY LN, SUITE 205, EDEN PRAIRIE, MN 55344-7847
(612) 225-0176
(612) 808-6738
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34597
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
946883800
—
MN
01
—
H300279329
MEDICARE PTAN
MN
Enumeration date
04/26/2017
Last updated
03/08/2018
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