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NPI Code Detail

MEDICARE: DR. PAUL J GRUSZKA M.D.

MEDICARE: DR. PAUL J GRUSZKA 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
1207X00000XOrthopaedic Surgery Physician01039250AIN

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 : 1295733889
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL J GRUSZKA M.D.
Provider Business Mailing Address
First Line : 601 GATEWAY BLVD N
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-9658
Country : US
Telephone Number : 219-921-1444
Fax Number : 219-921-5303
Provider Business Practice Location Address
First Line : 601 GATEWAY BLVD N
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-9658
Country : US
Telephone Number : 219-921-1444
Fax Number : 219-921-5303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 12/18/2024

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