# MARSHALL SALVATORE GRILLO JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1730114448
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 0102203257 | VA | — |
| 2086S0129X | Vascular Surgery Physician | 011005 | AZ | — |
| 2086S0129X | Vascular Surgery Physician | 2205 | TN | — |
| 2086S0129X | Vascular Surgery Physician | 5101011025 | MI | — |
| 2086S0129X | Vascular Surgery Physician | OS010217L | PA | — |
| 2086S0129X | Vascular Surgery Physician | OS20499 | FL | Yes |
| 2086S0129X | Vascular Surgery Physician | TP053 | KY | — |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 09/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000566339 | ANTHEM | KY |
| 05 | — | 0017202200012 | — | PA |
| 05 | — | 1730114448 | — | VA |
| 01 | — | 176254 | BS HIGHMARK | PA |
| 01 | — | 821942 | 1ST PRIORITY HEALTHCARE | PA |
| 05 | — | PENDING | — | FL |
| 01 | — | V0803 | HFMG | FL |