Male or Other

Charles J. Grodzin MD

Pulmonary Disease Physician in Atlanta, GA(View on Map)

Full Name

Charles J Grodzin MD

NPI Number

1215904859

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/02/2006

Specialties

(Taxonomies)

Code

207RP1001X

Primary Taxonomy

Yes

Licenses

State

Georgia
Texas

License Number

071760
L0226

Contact
Information

Purpose

Mailing
Location

Address

550 PEACHTREE ST NE
550 PEACHTREE ST NE

City

Atlanta
Atlanta

State

GA
GA

Postal Code

30308-2212
30308-2212

Country

US
US

Telephone Number

(404) 686-4411
(404) 686-4411

Identifiers

Identifier

142057203
142058002
142057204
290013827
290013828
8A2490
142057201

Identifier State

TX
TX
TX
TX
TX
TX
TX

Identifier Issuer

Unknown
Unknown
Unknown
RR MEDICARE DENTO CO
RR MEDICARE DALLAS CO
BCBS
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/08/2015

Provider Address

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