Individual provider · Type 1 NPI

Ethan Alexander Grandel, MD

Student in an Organized Health Care Education/Training Program · Albuquerque, NM

NPI number 1780478610 Active

Practice location

1 University Of New Mexico, MSC10 5590
Albuquerque, NM 87131

Call (505) 272-2345 Map

Fax (505) 272-2374

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XRS2025-0112 (NM)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1780478610

Ethan Alexander Grandel, MD's National Provider Identifier is 1780478610, issued on Apr 7, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Albuquerque, NM. The record was last updated on May 21, 2025.