Provider Demographics
NPI:1780953828
Name:GEORGE GRUNER MD, PLC
Entity type:Organization
Organization Name:GEORGE GRUNER MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-320-5778
Mailing Address - Street 1:909 HIOAKS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4038
Mailing Address - Country:US
Mailing Address - Phone:804-320-5778
Mailing Address - Fax:804-330-2841
Practice Address - Street 1:909 HIOAKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4038
Practice Address - Country:US
Practice Address - Phone:804-320-5778
Practice Address - Fax:804-330-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035092261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty