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NPI Code Detail

MEDICARE: DENIS MALTZ GRUTCKI M.D.

MEDICARE: DENIS MALTZ GRUTCKI M.D.
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
1207L00000XAnesthesiology Physician72494WI
2207L00000XAnesthesiology PhysicianME164409FL

General Provider Information

NPI Number : 1922488568
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENIS MALTZ GRUTCKI M.D.
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-236-8100
Fax Number : 715-236-8104
Provider Business Practice Location Address
First Line : 3476 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2000
Country : US
Telephone Number : 954-475-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 04/19/2024

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