Healthcare Provider Details

I. General information

NPI: 1093755639
Provider Name (Legal Business Name): ALEXANDER ASHER GRUNSFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 RIVERVIEW AVE STE 202
NORFOLK VA
23510-1065
US

IV. Provider business mailing address

301 RIVERVIEW AVE STE 202
NORFOLK VA
23510-1065
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-9015
  • Fax: 757-510-9041
Mailing address:
  • Phone: 757-252-9015
  • Fax: 757-510-9041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101239157
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number0101239157
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: