Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35-123937 | OH |
NPI | 1073775508 |
---|---|
Provider Name | Dr. Brian Michael Grawe |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45219-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 05/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0105612 | (05) | OH |