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NPI Code Detail

MEDICARE: DR. MICHAEL JAMES GRAU DMD

MEDICARE: DR. MICHAEL JAMES GRAU DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204E00000XOral & Maxillofacial Surgery (D.M.D.)16669OH

General Provider Information

NPI Number : 1043202690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JAMES GRAU DMD
Provider Business Mailing Address
First Line : 3805 EDWARDS RD STE 160
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-1948
Country : US
Telephone Number : 513-321-9627
Fax Number : 513-321-9629
Provider Business Practice Location Address
First Line : 3805 EDWARDS RD STE 160
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-1948
Country : US
Telephone Number : 513-321-9627
Fax Number : 513-321-9629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 12/21/2020

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