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Individual

DR. ANTHONY PETER GRELLO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 609-6350
Mailing address
PO BOX 1070, CHARLOTTE, NC 28201-1070
(800) 476-8646
(919) 382-3210

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200500570
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1397J
BCBSNC
NC
05
5901468
NC
Enumeration date
08/09/2005
Last updated
05/02/2013
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