Individual
JUAN E GRUNWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 FILBERT ST, PHILADELPHIA, PA 19104-2640
(215) 662-8100
Mailing address
3801 FILBERT ST, PHILADELPHIA, PA 19104-2640
(215) 662-8100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD030915E
PA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD030915E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009700960001
—
PA
Enumeration date
07/04/2006
Last updated
04/11/2018
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