MEDICARE: DAVID J GRONSKI 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	207QS0010X	Sports Medicine (Family Medicine) Physician	33507-020	WI

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

General Provider Information

NPI Number	:	1316990161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J GRONSKI MD

Provider Business Mailing Address
First Line	:	2501 W BELTLINE HWY
Second Line	:	SUITE 601
City	:	MADISON
State	:	WI
Zip	:	53713-2318
Country	:	US
Telephone Number	:	608-294-6464
Fax Number	:	608-288-6495

Provider Business Practice Location Address
First Line	:	2501 W BELTLINE HWY
Second Line	:	SUITE 601
City	:	MADISON
State	:	WI
Zip	:	53713-2318
Country	:	US
Telephone Number	:	608-294-6464
Fax Number	:	608-288-6495

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/18/2020

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Directions to “ DAVID J GRONSKI MD” Practice Location

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