Individual
MRS. CAROL DEROSA GRABOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Mailing address
108 DORNACH WAY, ADVANCE, NC 27006-7305
(336) 940-2407
(336) 940-2409
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102849
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8978751
—
NC
Enumeration date
07/25/2006
Last updated
03/07/2023
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