Andrew Scott Grivas Jr. (NPI# 1285658815, PAC ID# 6901829506) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1285658815 |
| PAC ID by PECOS | 6901829506 |
| Professional Enrollment ID | I20120328000334 |
| Full Name | Andrew Scott Grivas Jr. |
| Organization Legal Name | WILDWOOD SANITARIUM INCORPORATED |
| Address |
435 Lifestyle Lane Wildwood GA 30757-0129 |
| Phone Number | 7068201493 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS |
| Graduation Year | 1972 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3779571138 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 261337 | MISSOURI BAPTIST SULLIVAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1406 Missouri Blvd, Suite 1, Jefferson City, MO 65109-1737 | ||
| 435 Lifestyle Lane, Wildwood, GA 30757-0129 | 7068201493 | WILDWOOD SANITARIUM INCORPORATED |
| Organization Legal Name | WILDWOOD SANITARIUM INCORPORATED |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Viktorija Rimko | Nurse Practitioner | Wildwood Sanitarium Incorporated | 435 Lifestyle Ln, Wildwood, GA 30757-0129 |
| Roby Ann Sherman | Internal Medicine | Wildwood Sanitarium Incorporated | 435 Lifestyle Lane, Wildwood, GA 30757-0129 |
| Edward Sigh | Chiropractic | Wildwood Sanitarium Incorporated | 435 Lifestyle Ln, Wildwood, GA 30757-0129 |
| Justin L Neubrander | Physician Assistant | Wildwood Sanitarium Incorporated | 435 Lifestyle Lane, Wildwood, GA 30757-0129 |
| Street Address |
435 LIFESTYLE LANE |
| City | WILDWOOD |
| State | GA |
| Zip | 30757-0129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roby Ann Sherman | Internal Medicine | Wildwood Sanitarium Incorporated | 435 Lifestyle Lane, Wildwood, GA 30757-0129 |
| Justin L Neubrander | Physician Assistant | Wildwood Sanitarium Incorporated | 435 Lifestyle Lane, Wildwood, GA 30757-0129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Viktorija Rimko | Nurse Practitioner | Wildwood Sanitarium Incorporated | 435 Lifestyle Ln, Wildwood, GA 30757-0129 |
| Edward Sigh | Chiropractic | Wildwood Sanitarium Incorporated | 435 Lifestyle Ln, Wildwood, GA 30757-0129 |
| City | WILDWOOD |
| Zip Code | 30757 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WILDWOOD + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Andrew Scott Grivas Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.