MEDICARE: DR. PETER MICHAEL GRONDZIOWSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD044862L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447250469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER MICHAEL GRONDZIOWSKI MD

Provider Business Mailing Address
First Line	:	1580 MCLAUGHLIN RUN RD
Second Line	:	SUITE 212
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	412-319-7215
Fax Number	:	412-319-7041

Provider Business Practice Location Address
First Line	:	1580 MCLAUGHLIN RUN RD
Second Line	:	SUITE 212
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	412-319-7215
Fax Number	:	412-319-7041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	08/26/2014

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Directions to “ DR. PETER MICHAEL GRONDZIOWSKI MD” Practice Location

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