Organization
MARTHA A. GRISWOLD MD PC
Active
Organization
MARTHA A. GRISWOLD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA A. GRISWOLD M.D., P.C. (OWNER)
(804) 861-8444
Entity
Organization
Contact information
Practice address
507 S SYCAMORE ST, PETERSBURG, VA 23803-5037
(804) 861-8444
(804) 862-1582
Mailing address
507 S SYCAMORE ST, PETERSBURG, VA 23803-5037
(804) 861-8444
(804) 862-1582
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101033077
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006097812
—
VA
01
—
1770771248
NPI
—
01
—
C10320
MEDICARE GROUP
—
Enumeration date
10/10/2007
Last updated
01/07/2008
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