Dr. Brian Dwight Grudem is a White Bear Lake, Minnesota based male Optometrist with 45 years of experience in Optometry. He completed his graduation from Pacific University - College Of Optometry in 1979. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. Brian Dwight Grudem is LD1732000 for Optometry in Minnesota. Dr. Brian Dwight Grudem examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. He completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. He is a eye health care professional who is state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Profile:
Dr. Brian Dwight Grudem speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Optometry
Credentials:
O.D.
Experience:
45+ years
Medical School Attended:
Pacific University - College Of Optometry
Graduation Year:
1979
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
4720 White Bear Pkwy, White Bear Lake, Minnesota, 55110-3336
Phone:
651-426-2747
Fax:
651-426-9838
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
6901893460
Enrollment ID:
I20040429000067
NPI Number:
1194717298
NPI Enumeration Date:
16 Aug, 2005
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Brian Dwight Grudem are as mentioned below.
License Number
Specialization
State
Status
LD1732000
Optometry
Minnesota
Primary
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Dr. Brian Dwight Grudem has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Eagan Eye Clinic Llc (0345220745)
28
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Brian Dwight Grudem such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
P00124841
Other
Minnesota
MEDICARE RAILROAD RETIREM
965400656001
Other
Minnesota
PREFERRED ONE
0N456GR
Other
Minnesota
BLUE CROSS BLUE SHIELD
HP29577
Other
Minnesota
HEALTH PARTNERS
22-02690
Other
Minnesota
MEDICA
22-02779
Other
Minnesota
MEDICA
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
4720 White Bear Pkwy, White Bear Lake, Minnesota
Zip:
55110-3336
Phone Number:
651-426-2747
Fax Number:
651-426-9838
Patients can reach Dr. Brian Dwight Grudem at 4720 White Bear Pkwy, White Bear Lake, Minnesota or can call to book an appointment on 651-426-2747. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.