Douglas C Gremban, MD is a
Family Medicine physician based in Mountain, Wisconsin. Douglas C Gremban is licensed to practice in Wisconsin (license number 23967-020) and his current practice location is 14353 State Highway 32 64, Mountain, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(715) 276-1600.
NPI number for Douglas C Gremban is 1316940927 and his current mailing address is 14353 State Highway 32 64, Mountain, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316940927.
Physician's Profile
| Full Name | Douglas C Gremban |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 14353 State Highway 32 64, Mountain, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1316940927
- Provider Enumeration Date: 05/27/2005
- Last Update Date: 09/02/2014
Medical Identifiers
Medical identifiers for Douglas C Gremban such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316940927 | NPI | - | NPPES |
| 11014110 | Medicaid | WI | |
| 1568552958 | Other | WI | MPCC NPI |
| 1851477913 | Other | WI | CMH NPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 23967-020 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Douglas C Gremban is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Douglas C Gremban, MD
14353 State Highway 32 64,
Mountain, WI 54149-9656
Ph: (715) 276-1600 | Douglas C Gremban, MD
14353 State Highway 32 64,
Mountain, WI 54149-9656
Ph: (715) 276-1600 |
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