Individual
KEITH GRABOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4205 MUNDY MILL PL, OAKWOOD, GA 30566-2566
(770) 532-0800
Mailing address
125 OLD WHITE OAK TRL, DAWSONVILLE, GA 30534-6353
(770) 780-0784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9756
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3633121300
NATIONAL REGISTRY OF CERTIFIED MEDICAL EXAMINERS
DC
01
—
9756
GEORGIA COMPOSITE MEDICAL BOARD PHYSICIAN ASSISTANT LICENSE
GA
Enumeration date
08/18/2020
Last updated
08/18/2020
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