Ivan M Grynyshin MD

NPI 1124000369 - Anesthesiology - 207L00000X

NPI Details
NPI 1124000369
Gender Male
Enumeration Date 11/15/2005
Last Updated 04/20/2009
Entity Type Individual
Active Over 11 years ago
Practice Location
420 S JACKSON ST
POTTSVILLE PA, 17901-3625, US
Phone (570) 346-7797
Fax
Business Location
PO BOX 390
SCRANTON PA, 18501-0390, US
Phone (570) 346-7797
Fax (570) 342-9802
Toxanomy
Taxonomy Code 207L00000X
License State Pennsylvania
License Number MD423998
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According to our database, Ivan M Grynyshin MD NPI is 1124000369, taxonomy code is 207L00000X and license number is MD423998, license state is located at Pennsylvania. Ivan M Grynyshin MD physically located at 420 S Jackson St, Pottsville PA, 17901-3625. NPI Number Ivan M Grynyshin MD has the Individual type.

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1124000369 NPI number is provided on an as is basis without warranty of any kind. 1124000369 is maintained by the National Plan & Provider Enumeration System. The contents of Ivan M Grynyshin MD are for informational purposes only.