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Individual

DR. LORI-ANNE TUNGPALAN-GRONDOLSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-7540
Mailing address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-7540

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
14755
HI
207L00000X
Anesthesiology Physician
35084620
OH
207L00000X
Anesthesiology Physician
Primary
44120
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000344370
ANTHEM
OH
05
2515362
OH
01
P00180905
RAILROAD MEDICARE
OH
Enumeration date
09/01/2006
Last updated
12/28/2020
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