Provider Demographics
NPI:1215901327
Name:GRUEN, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:GRUEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:2ND FLOOR WOMEN'S CENTER
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-276-4152
Mailing Address - Fax:
Practice Address - Street 1:32 STRAWBERRY HILL CT
Practice Address - Street 2:2ND FLOOR WOMEN'S CENTER
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-276-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0366932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G73229Medicare UPIN