# PATRONUS PHYSICIANS GROUP PC

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

## Provider details

- **NPI number:** 1851830178
- **Authorized official:** CAREY GRAINGER (CEO)
- **Authorized official phone:** (404) 822-4823

## Contact information

- **Practice address:** 8000 TOWERS CRESCENT DR, SUITE 1350, VIENNA, VA 22182-6207
- **Practice address phone:** (866) 450-1918
- **Mailing address:** 8000 TOWERS CRESCENT DR, SUITE 1350, VIENNA, VA 22182-6207
- **Mailing address phone:** (866) 450-1918

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084V0102X | Vascular Neurology Physician | — | NULL | — |
| 2084V0102X | Vascular Neurology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2017
- **Last updated:** 02/20/2017