Individual
DAVID L GROTELUSCHEN
Active
Individual
DAVID L GROTELUSCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
44953
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104894036
—
MI
05
—
34871500
—
WI
01
—
DG088696
MICHIGAN BCBS
MI
Enumeration date
04/19/2006
Last updated
12/20/2021
Update your record
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