Individual
DAVID LAWRENCE GRISELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
209 CRESCENT AVE, GREENVILLE, SC 29605-2814
(864) 436-7447
Mailing address
209 CRESCENT AVE, GREENVILLE, SC 29605-2814
(864) 436-7447
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
1260
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012603
—
SC
05
—
200491700
—
IN
05
—
2478902
—
OH
05
—
64087455
—
KY
01
—
P00166987
RAILROAD MEDICARE
OH
Enumeration date
08/17/2005
Last updated
02/08/2021
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