Provider Demographics
NPI:1093748063
Name:W. ROBERT GRONEWALD, M.D., P.C.
Entity Type:Organization
Organization Name:W. ROBERT GRONEWALD, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:W. ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-581-4646
Mailing Address - Street 1:751 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5812
Mailing Address - Country:US
Mailing Address - Phone:423-581-4618
Mailing Address - Fax:
Practice Address - Street 1:751 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-5812
Practice Address - Country:US
Practice Address - Phone:423-581-4618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty