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General NPI Number Information
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NPI Number | 1639303290
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Entity Type | Organization
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Legal Business Name | DAVID GRISCHKAN MD INC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 24025 COMMERCE PARK ROAD
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City | BEACHWOOD
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State | OH
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Zip | 44122
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Country | US
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Telephone | 216-591-1420
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Fax | 216-591-1424
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Provider Business Mailing Address
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Address Line | 24025 COMMERCE PARK
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City | BEACHWOOD
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State | OH
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Zip | 44122
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Country | US
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Telephone | 216-591-1420
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Fax | 216-591-1424
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID MICHAEL GRISCHKAN
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Credential | MD
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Telephone | 216-591-1420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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