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Individual

MICHAEL JEROME GRADY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1311 MILSTEAD AVE NE, CONYERS, GA 30012-3829
(770) 483-2368
(770) 785-5080
Mailing address
50 UPLAND TRL, OXFORD, GA 30054-2923
(770) 483-2368
(770) 785-5080

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
029875
GA

Other

Enumeration date
02/20/2006
Last updated
07/08/2007
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