Individual
JUSTIN GROENEWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
(651) 254-9673
Mailing address
PO BOX 1309, MS 21110Q, MINNEAPOLIS, MN 55440-1309
(651) 254-3456
(651) 254-9673
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
61454
MN
207P00000X
Emergency Medicine Physician
67786
WI
207R00000X
Internal Medicine Physician
61454
MN
Other
Enumeration date
05/16/2014
Last updated
07/18/2025
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