Individual provider · Type 1 NPI

Grayson W. Blomberg, PA-C

Surgical Physician Assistant · Plymouth, MN

NPI number 1003057118 Active

Practice location

15700 37th Ave N Ste 150
Plymouth, MN 55446-3675

Call (651) 968-5201 Map

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X10560 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1003057118

Grayson W. Blomberg, PA-C's National Provider Identifier is 1003057118, issued on Mar 19, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Plymouth, MN. The record was last updated on Jul 21, 2022.