Individual
DR. THOMAS E GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6704
(410) 328-4124
Mailing address
PO BOX 64793, BALTIMORE, MD 21264-4793
(410) 328-6704
(410) 328-4124
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D60747
MD
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D60747
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404697800
—
MD
Enumeration date
06/09/2006
Last updated
03/14/2008
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