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General NPI Number Information
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NPI Number | 1336149996
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Entity Type | Individual
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Provider Name | CHANDRA YVETTE GRAVELY MD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 10700 MONTGOMERY RD SUITE 311
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City | CINCINNATI
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State | OH
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Zip | 45242
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Country | US
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Telephone | 513-891-0211
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Fax | 513-792-5945
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Provider Business Mailing Address
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Address Line | 4422 CARVER WOODS DR STE 100
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City | BLUE ASH
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State | OH
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Zip | 45242-5599
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Country | US
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Telephone | 513-891-0211
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Fax | 513-792-5945
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35.062556
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License Number State | OH
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