Organization
PROMED PREFERRED WI 2 SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEV GRINMAN MD (PRESIDENT)
(615) 499-3165
Entity
Organization
Contact information
Practice address
100 WILBURN RD STE 100, SUN PRAIRIE, WI 53590-1478
(615) 499-3165
Mailing address
329 S OYSTER BAY RD # 2059, PLAINVIEW, NY 11803-3301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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