| Mark L Gravlee, MD | |
|
2500 Hospital Boulevard, Suite 420, Roswell, GA 30076-4919 | |
| (770) 410-4661 | |
| (770) 410-4664 |
| Full Name | Mark L Gravlee |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 39 Years |
| Location | 2500 Hospital Boulevard, Roswell, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306942115 | NPI | - | NPPES |
| 000454902D | Medicaid | GA | |
| 000454902E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 034355 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar North Fulton Hospital | Roswell, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark L Gravlee, MD 2500 Hospital Blvd Ste 290, Roswell, GA 30076-4918 Ph: (470) 956-4560 | Mark L Gravlee, MD 2500 Hospital Boulevard, Suite 420, Roswell, GA 30076-4919 Ph: (770) 410-4661 |
Dr. Craig Rodney Mccready, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4500 Hospital Blvd Ste 230, Roswell, GA 30076 Phone: 470-956-4560 Fax: 770-475-8968 | |
Theolyn N Price, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2500 Hospital Blvd Ste 420, Roswell, GA 30076 Phone: 704-249-7327 Fax: 770-421-0228 | |
Dr. Desiree Villadolid, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1825 Old Alabama Rd, Roswell, GA 30076 Phone: 305-965-3374 | |
Dr. Alan Lee Goldman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2500 Hospital Blvd Ste 150, Roswell, GA 30076 Phone: 770-442-3117 Fax: 678-701-1722 | |
Dr. James Clifton Haynes, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2500 Hospital Blvd Ste 290, Roswell, GA 30076 Phone: 470-956-4560 Fax: 770-475-8968 | |
Jessica Ann Bilz, MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 2500 Hospital Blvd Ste 410, Roswell, GA 30076 Phone: 470-956-4720 |