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General NPI Number Information
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NPI Number | 1447256862
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Entity Type | Individual
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Provider Name | MANDEEP S GREWAL MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 251 N LYERLY ST SUITE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2739
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Country | US
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Telephone | 423-826-8000
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Fax | 423-826-8015
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Provider Business Mailing Address
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Address Line | 2300B E 3RD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2734
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Country | US
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Telephone | 423-702-7900
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Fax | 423-702-7905
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 26508
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 035642
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License Number State | GA
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