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NPI Code Detail

MEDICARE: DR. LAWRENCE JOEL GRILL M.D.

MEDICARE: DR. LAWRENCE JOEL GRILL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician45971NJ
2207R00000XInternal Medicine PhysicianMD493378PA

General Provider Information

NPI Number : 1063443844
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE JOEL GRILL M.D.
Provider Business Mailing Address
First Line : 500 SCOTT ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-5616
Country : US
Telephone Number : 570-824-1700
Fax Number : 570-824-1300
Provider Business Practice Location Address
First Line : 500 SCOTT ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-5616
Country : US
Telephone Number : 570-824-1700
Fax Number : 570-824-1300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 04/09/2026

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