Individual
MR. RICKY D GRISSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
Mailing address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT STREET, BOSTON, MA 02114
(617) 726-2967
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
L-232504
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
A121170
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
MD15414
RI
Other
Enumeration date
06/15/2007
Last updated
10/07/2020
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