Individual
GRADY LUKE EDGE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
VCUHS DEPT OF IM RESIDENCY/FELLOWSHIP, 980509, 1250 E. MARSHALL STREET, RICHMOND, VA 23298-0509
(804) 828-8786
Mailing address
VCUHS GMEA, BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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