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Individual

MICHAEL J GRAVELEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 YORK RD STE 108, JENKINTOWN, PA 19046-2852
(215) 481-2725
(215) 481-3013
Mailing address
500 YORK RD STE 108, JENKINTOWN, PA 19046-2852
(215) 481-2725
(215) 481-3013

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD-421514
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD-421514
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101350285-0001
PA
Enumeration date
10/28/2005
Last updated
03/10/2018
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