Gravlee, Mark L
Gravlee, Mark L is an sole proprietor health care provider with primary practice located at 2500 Hospital Boulevard Suite 420, Roswell GA 30076-4919. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gravlee, Mark L can be contacted via phone (770) 410-4661.Contact Information
Primary practice address
2500 Hospital Boulevard Suite 420
Roswell GA 30076-4919
Phone: (770) 410-4661
Fax: (770) 410-4664
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 034355 | Georgia |
Profile Details
| NPI number | 1306942115 |
|---|---|
| LBN Legal business name | Gravlee, Mark L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Oct 14th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306942115 | NPPES |
| Georgia | MEDICAID | 000454902D | |
| Georgia | MEDICAID | 000454902E |
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