Mark A Granrud, PA-C

NPI #1043286222 in Nampa, Idaho

Provider Information

NPI Number: 1043286222
Entity Type: Individual
Name: Mark A Granrud, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 27, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 215 E HAWAII AVENUE
City: Nampa
State: Idaho
ZIP Code: 83686
Phone: (208) 463-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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