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NPI Code Detail

MEDICARE: TED GRACE M.D.

MEDICARE: TED GRACE 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
1171W00000XContractor35-039747OH

General Provider Information

NPI Number : 1699749176
Entity Type Code : Individual
Provider Name (Legal Business Name) : TED GRACE M.D.
Provider Business Mailing Address
First Line : 1875 MILLIKIN RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-2200
Country : US
Telephone Number : 614-292-0110
Fax Number : 614-247-6074
Provider Business Practice Location Address
First Line : 1875 MILLIKIN RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-2200
Country : US
Telephone Number : 614-292-0110
Fax Number : 614-247-6074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 07/08/2007

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Directions to “ TED GRACE M.D.” Practice Location

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