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General NPI Number Information
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NPI Number | 1326069725
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Entity Type | Individual
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Provider Name | LEE BRYAN GROTTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5399 MAYFIELD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-2457
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Country | US
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Telephone | 440-461-7488
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Fax |
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Provider Business Mailing Address
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Address Line | 22870 HADDEN RD
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City | EUCLID
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State | OH
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Zip | 44117-2054
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Country | US
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Telephone | 216-383-0800
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 35045205
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35045205
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35045205
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License Number State | OH
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