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NPI Code Detail

MEDICARE: BRIAN F GRODEN MD

MEDICARE:   BRIAN F GRODEN  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
1208000000XPediatrics Physician71961MA

Other Identifiers

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

General Provider Information

NPI Number : 1215905443
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN F GRODEN MD
Provider Business Mailing Address
First Line : 81 HAWTHORN ST # R
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-3429
Country : US
Telephone Number : 508-961-2403
Fax Number :
Provider Business Practice Location Address
First Line : 81 HAWTHORN ST # R
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-3429
Country : US
Telephone Number : 508-961-2403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 12/14/2011

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Directions to “ BRIAN F GRODEN MD” Practice Location

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