ROBERT E GRONDAHL (NPI# 1922191816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922191816 |
| Entity Type | Individual |
| Full Name | ROBERT E GRONDAHL |
| Credential | MD |
| Practice Address |
1111 Ronald Reagan Pkwy Ste 1400 Avon IN 46123-7085 |
| Mailing Address |
1111 Ronald Reagan Pkwy Ste C1400 Avon IN 46123-7085 |
| Practice Telephone | 3172172777 |
| Practice Fax Number | 3172172775 |
| Mailing Telephone | 3172172777 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 01059882 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200525570 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16 Fahy St Ste 108, Belfast, ME 049156029 | 2075054345 | 2075054349 |
| Street Address |
1111 RONALD REAGAN PKWY STE 1400 |
| City | AVON |
| State | IN |
| Zip Code | 46123-7085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073606984 | Travis A Richardson | Obstetrics & Gynecology | 1111 Ronald Reagan Pkwy Ste 1400, Avon, IN 46123-7085 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730747445 | Colorado Mountain Medical, LLC | Obstetrics & Gynecology | 50 Buck Creek Road, Suite 200, Avon, CO 81620 | 2019-05-29 |
| 1821446774 | Jessica Mae Healey | Obstetrics & Gynecology | 1111 Ronald Reagan Pkwy Ste C1400, Avon, IN 46123-7085 | 2016-06-01 |
| 1295984144 | Derma Taut International PC | Obstetrics & Gynecology | 37347 Us Highway 6 & 24, Suite 214, Avon, CO 81620-3387 | 2008-09-16 |
| 1619069002 | Sharon S Walker Watkins | Obstetrics & Gynecology | 1111 N. Ronald Reagan Parkway, Suite C1600, Avon, IN 46123-7085 | 2006-09-29 |
| 1487745881 | Matthew Saidel | Obstetrics & Gynecology | 20 West Avon Rd, Avon, CT 06001 | 2006-09-28 |
| 1366497810 | Alison D Lemberg | Obstetrics & Gynecology | 36901 American Way, Avon, OH 44011 | 2006-05-23 |
| 1952396889 | Andrea G Huffman | Obstetrics & Gynecology | 6911 E Us Highway 36, Avon, IN 46123-8926 | 2005-09-16 |
| 1730530429 | Krystal Reynolds | Obstetrics & Gynecology | 6911 E Us Highway 36, Avon, IN 46123-8926 | 2016-06-24 |
| 1295963775 | Julia Lauren Ruckman-long | Obstetrics & Gynecology | 6911 E Us Highway 36, Avon, IN 46123-8926 | 2009-06-23 |
| 1639312168 | Laurie Marie Van Donselaar | Obstetrics & Gynecology | 6911 E Us Highway 36, Avon, IN 46123-8926 | 2009-04-14 |
| Find all providers in AVON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.