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General NPI Number Information
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NPI Number | 1528339645
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Entity Type | Organization
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Legal Business Name | THE GRAIVIER CENTER
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 3333 OLD MILTON PARKWAY SUITE 260
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City | ALPHARETTA
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State | GA
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Zip | 30005-4626
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Country | US
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Telephone | 770-772-0695
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Fax | 770-751-0409
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Provider Business Mailing Address
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Address Line | 3333 OLD MILTON PARKWAY SUITE 260
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City | ALPHARETTA
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State | GA
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Zip | 30005-4626
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Country | US
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Telephone | 770-772-0695
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Fax | 770-751-0409
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Authorized Official
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Title or Position | OWNER
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Name | DR. MILES GRAIVIER
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Credential | M.D.
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Telephone | 770-751-0695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 060245
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License Number State | GA
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