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NPI Code Detail

MEDICARE: DR. REETU GREWAL M.D.

MEDICARE:  DR. REETU  GREWAL  M.D.
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
1207Q00000XFamily Medicine Physician28064SC
2207Q00000XFamily Medicine PhysicianME101687FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093823569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REETU GREWAL M.D.
Provider Business Mailing Address
First Line : PO BOX 44008
Second Line : UFJP PROVIDER ENROLLMENT
City : JACKSONVILLE
State : FL
Zip : 32231-4008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5460 BLANDING BLVD STE 3
Second Line : UFJP ANCHOR PLAZA
City : JACKSONVILLE
State : FL
Zip : 32244-1957
Country : US
Telephone Number : 904-633-0610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2006
Last Update Date : 08/19/2009

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Directions to “ DR. REETU GREWAL M.D.” Practice Location

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