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General NPI Number Information
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NPI Number | 1922018720
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Entity Type | Individual
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Provider Name | MICHAEL DAVID GRINDSTAFF PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4480 ATLANTA HWY
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City | LOGANVILLE
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State | GA
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Zip | 30052-7313
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Country | US
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Telephone | 770-554-4031
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Fax |
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Provider Business Mailing Address
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Address Line | 2110 PRICKLY PEAR WALK
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-6374
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Country | US
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Telephone | 770-995-8309
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16102
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License Number State | GA
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