Individual
DR. WAYNE ALVIN GRUNDMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 MEADOWCREST ST, #220, GRETNA, LA 70056-5255
(504) 391-7595
(504) 391-7599
Mailing address
120 MEADOWCREST ST, #220, GRETNA, LA 70056-5255
(504) 391-7595
(504) 391-7599
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD 014877
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1324299
—
LA
Enumeration date
08/24/2006
Last updated
07/08/2007
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