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Individual

HOWARD O GRUNDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24 JOLIET ST, DYER, IN 46311-1705
(219) 864-2036
(219) 864-2253
Mailing address
431 WESTMINSTER DR, BURR RIDGE, IL 60527-8338
(219) 864-2107
(219) 864-2649

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01037603A
IN
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME159626
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100201440
IN
Enumeration date
09/09/2005
Last updated
11/07/2022
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