Individual
DR. LEE GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1742 OAK RD, SNELLVILLE, GA 30078
(770) 638-1401
(770) 638-1402
Mailing address
1742 OAK RD, SNELLVILLE, GA 30078-2234
(770) 638-1401
(770) 638-1402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046856
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312787872A
—
GA
Enumeration date
03/26/2012
Last updated
08/21/2018
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