Individual
DR. JEFFREY GRONDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-5864
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 484-6700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
894-L
MS
207RP1001X
Pulmonary Disease Physician
25854
MS
207RP1001X
Pulmonary Disease Physician
Primary
4301506492
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01787000
—
MS
Enumeration date
07/02/2013
Last updated
08/14/2023
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