Individual
DR. JOHN W GRUDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18989
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004859
KAISER-COMMERCIAL NUMBER
—
05
—
01189893
—
CO
Enumeration date
02/16/2007
Last updated
06/04/2015
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