Gronka, Edward Scott

Gronka, Edward Scott is an individual health care provider with primary practice located at 874 W Lanier Ave One Prestige Park Suite 100, Fayetteville GA 30214-1511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Gronka, Edward Scott can be contacted via phone (770) 461-4000.

Contact Information

Primary practice address
874 W Lanier Ave One Prestige Park Suite 100 Fayetteville GA 30214-1511
Phone: (770) 461-4000
Fax: (770) 461-2790
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 035431 Georgia

Profile Details

NPI number 1306838099
LBN Legal business name Gronka, Edward Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Aug 28th, 2007 - about 19 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 1306838099 NPPES
Georgia MEDICAID 00502433A

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