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Individual

DR. THOMAS A. GRILLO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1700 TREE LANE RD, SUITE 230, SNELLVILLE, GA 30078-6782
(770) 979-4700
(770) 979-1060
Mailing address
1700 TREE LANE RD, SUITE 230, SNELLVILLE, GA 30078-6782
(770) 979-4700
(770) 979-1060

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
020720
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00240831A
GA
Enumeration date
06/12/2006
Last updated
07/08/2007
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