Organization
GRENVILLE MACHADO M.D.,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRENVILLE MACHADO (PRESIDENT)
(330) 666-2022
Entity
Organization
Contact information
Practice address
2839 COPLEY RD, COPLEY, OH 44321-2154
(330) 666-2022
Mailing address
2839 COPLEY RD, COPLEY, OH 44321-2154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2718581
—
OH
Enumeration date
09/15/2006
Last updated
11/29/2007
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