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General NPI Number Information
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NPI Number | 1730114448
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Entity Type | Individual
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Provider Name | MARSHALL SALVATORE GRILLO JR. DO
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 600 HEALTH PARK BLVD STE G
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City | GRAND BLANC
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State | MI
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Zip | 48439-2558
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Country | US
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Telephone | 810-606-1660
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Fax | 810-606-1655
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Provider Business Mailing Address
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Address Line | 600 HEALTH PARK BLVD STE G
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City | GRAND BLANC
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State | MI
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Zip | 48439-2558
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Country | US
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Telephone | 810-606-1660
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Fax | 810-606-1655
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS20499
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 2205
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0102203257
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 011005
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | TP053
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 5101011025
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS010217L
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License Number State | PA
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