Individual
GERALD E GRONBORG
Active
Individual
GERALD E GRONBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC003442L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC003442L
PA
213ER0200X
Radiology Podiatrist
SC003442L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003442L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060525
UNISON
PA
01
—
000706203
KEYSTONE HEALTH PLAN
PA
05
—
0012762560009
—
PA
05
—
0012762560010
—
PA
05
—
0012762560012
—
PA
01
—
0857830000
PPO PROGRAM INDEPENDENCE
PA
01
—
1022107
GATEWAY
PA
01
—
200069
UPMC
PA
01
—
21128765012
BEECH STREET
PA
01
—
2805196
AETNA HMO QPOS
PA
01
—
480013965
RR MEDICARE INDIVIDUAL
PA
01
—
5166987
PPNI
PA
01
—
7318023
MAMSI
PA
01
—
826758
BLUE SHIELD GROUP
PA
01
—
CC2226
RR MEDICARE GROUP
PA
01
—
GR706203
BLUE SHIELD INDIVIDUAL
PA
01
—
P 54229714
MULTIPLAN
PA
Enumeration date
01/09/2006
Last updated
08/22/2025
Update your record
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