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General NPI Number Information
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NPI Number | 1710953088
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Entity Type | Individual
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Provider Name | ERIC D GRUEN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 400 DAWSON COMMONS CIR STE 420
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City | DAWSONVILLE
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State | GA
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Zip | 30534
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Country | US
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Telephone | 706-216-8637
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Fax | 815-550-9967
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Provider Business Mailing Address
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Address Line | 400 DAWSON COMMONS CIR STE 420
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City | DAWSONVILLE
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State | GA
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Zip | 30534-6269
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Country | US
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Telephone | 706-216-8637
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Fax | 815-550-9967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N004948
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD000924
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License Number State | GA
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