MEDICARE: DR. TERRY L. GRAMLICH MD

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
1	207ZC0500X	Cytopathology Physician	35-060998G	OH
2	207ZC0500X	Cytopathology Physician	034354	GA
3	207ZC0500X	Cytopathology Physician	L8705	TX
4	207ZC0500X	Cytopathology Physician	ME90450	FL
5	207ZC0500X	Cytopathology Physician	MD421664	PA
6	207ZP0101X	Anatomic Pathology Physician	35-060998G	OH
7	207ZP0101X	Anatomic Pathology Physician	034354	GA
8	207ZP0101X	Anatomic Pathology Physician	L8705	TX
9	207ZP0101X	Anatomic Pathology Physician	ME90450	FL
10	207ZP0101X	Anatomic Pathology Physician	MD421664	PA

General Provider Information

NPI Number	:	1841275781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY L. GRAMLICH MD

Provider Business Mailing Address
First Line	:	14275 MIDWAY RD
Second Line	:	SUITE 400
City	:	ADDISON
State	:	TX
Zip	:	75001-3614
Country	:	US
Telephone Number	:	214-932-8029
Fax Number	:	610-271-4245

Provider Business Practice Location Address
First Line	:	7730 FIRST PL
Second Line	:	SUITE A
City	:	OAKWOOD VILLAGE
State	:	OH
Zip	:	44146-6719
Country	:	US
Telephone Number	:	800-331-7546
Fax Number	:	440-703-2155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/05/2013

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