Provider Demographics
NPI:1245283274
Name:GRAMITH, FREDERICK C (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:C
Last Name:GRAMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN260592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN105083OtherUCARE
MN01016774OtherDAKOTA CARE
MN1016774OtherPREFERRED ONE
MNHP13405OtherHEALTHPARTNERS
WI300028376OtherRAILROAD MEDICARE WI
MN300G7GROtherBLUE CROSS
MN1M525GROtherBLUE CROSS
MN22831OtherAMERICA'S PPO
MN252824OtherMIDLANDS CHOICE INC
WI30707100Medicaid
IA0531723Medicaid
MN300077264OtherRAILROAD MEDICARE MN
MN831770400Medicaid
MN300002957Medicare PIN
MNHP13405OtherHEALTHPARTNERS
IA0531723Medicaid
MN1016774OtherPREFERRED ONE
WI006856135Medicare PIN