Individual
BRIAN C GRINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 N OAK STREET EXT, VALDOSTA, GA 31605-1014
(229) 242-6061
(229) 242-6151
Mailing address
3301 N OAK STREET EXT, VALDOSTA, GA 31605
(229) 242-6061
(229) 242-6151
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
046966
GA
208000000X
Pediatrics Physician
Primary
046966
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000819706C
—
GA
05
—
000819706D
—
GA
05
—
000819706E
—
GA
05
—
003138857A
—
GA
05
—
875175410A
—
GA
05
—
901359126A
—
GA
05
—
901359126B
—
GA
Enumeration date
06/28/2006
Last updated
11/27/2023
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