Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 042165 | CT |
N | 207RH0002X | Hospice and Palliative Medicine | 042165 | CT |
N | 207RX0202X | Medical Oncology | 042165 | CT |
NPI | 1376520270 |
---|---|
Provider Name | Stephen H Grund |
First Address | Farmington, CT 06030-2212 |
Second Address | Farmington, CT 06030-2875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1376520270 | (05) | CT |
F69850 | (02) | CT |