Provider Demographics
NPI:1750686796
Name:GRUENEWALD, JAMES RICHARD (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:GRUENEWALD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:111 E WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4815
Mailing Address - Country:US
Mailing Address - Phone:414-290-6700
Mailing Address - Fax:414-290-6781
Practice Address - Street 1:111 E WISCONSIN AVE STE 2100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4809
Practice Address - Country:US
Practice Address - Phone:414-290-6700
Practice Address - Fax:414-290-6781
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2021-12-31
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant