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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306942115 NPPES
Georgia MEDICAID 000454902D
Georgia MEDICAID 000454902E

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