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General NPI Number Information
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NPI Number | 1598297632
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Entity Type | Individual
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Provider Name | ARIEL NICOLE GRADY M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1372 PEACHTREE ST NE STE 100
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City | ATLANTA
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State | GA
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Zip | 30309-3202
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Country | US
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Telephone | 470-964-1700
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Fax | 678-288-5639
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Provider Business Mailing Address
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Address Line | 1175 CASCADE PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30311-3090
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Country | US
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Telephone | 404-949-5183
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 85456
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License Number State | GA
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