Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 036074917 | IL |
Y | 207RG0100X | Gastroenterologist | 56101 | WI |
NPI | 1013931203 |
---|---|
Provider Name | Gary R Griglione |
First Address | Madison, WI 53715-1507 |
Second Address | Madison, WI 53715-1507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A03016 | (02) | IL |