| NPI | 1992721047 |
|---|---|
| Former Legal Business Name | GRANDEL MEDICAL |
| Entity Type | Organization |
| Authorized Contact | ALEXANDER RUDOI Physician 314-481-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO mo100186) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-11-13 |