Gronka, Edward Scott
Gronka, Edward Scott is an individual health care provider with primary practice located at 874 W Lanier Ave One Prestige Park Suite 100, Fayetteville GA 30214-1511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Gronka, Edward Scott can be contacted via phone (770) 461-4000.Contact Information
Primary practice address
874 W Lanier Ave One Prestige Park Suite 100
Fayetteville GA 30214-1511
Phone: (770) 461-4000
Fax: (770) 461-2790
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 035431 | Georgia |
Profile Details
NPI number | 1306838099 |
---|---|
LBN Legal business name | Gronka, Edward Scott |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 18th, 2005 |
Last updated | Aug 28th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1306838099 | NPPES |
Georgia | MEDICAID | 00502433A |
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