Blomberg, Grayson W
Blomberg, Grayson W is an individual health care provider with primary practice located at 15700 37Th Ave N Ste 150 , Plymouth MN 55446-3675. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Blomberg, Grayson W can be contacted via phone (651) 968-5201.Contact Information
Primary practice address
15700 37Th Ave N Ste 150
Plymouth MN 55446-3675
Phone: (651) 968-5201
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 10560 | Minnesota |
Profile Details
| NPI number | 1003057118 |
|---|---|
| LBN Legal business name | Blomberg, Grayson W |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2009 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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