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General NPI Number Information
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NPI Number | 1255513909
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Entity Type | Individual
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Provider Name | MANPREET SINGH GREWAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 1800 N FEDERAL HWY STE 101
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City | POMPANO BEACH
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State | FL
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Zip | 33062
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Country | US
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Telephone | 954-807-9545
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Fax |
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Provider Business Mailing Address
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Address Line | 4608 SWILCAN BRIDGE LN S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-5620
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME96458
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | ME96458
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License Number State | FL
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