# GRENVILLE MACHADO M.D.,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376649483
- **Authorized official:** GRENVILLE MACHADO (PRESIDENT)
- **Authorized official phone:** (330) 666-2022

## Contact information

- **Practice address:** 2839 COPLEY RD, COPLEY, OH 44321-2154
- **Practice address phone:** (330) 666-2022
- **Mailing address:** 2839 COPLEY RD, COPLEY, OH 44321-2154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 11/29/2007