Basic Information
| Provider Information | |||||||||
| NPI: | 1467938456 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREVEN | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | CRAIG MCCONNELL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | EMORY UNIVERSITY SCHOOL OF MEDICINE | ||||||||
| Address2: | 100 WOODRUFF CIRCLE, SUITE P375 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047275655 | ||||||||
| FaxNumber: | 4047270045 | ||||||||
| Practice Location | |||||||||
| Address1: | EMORY HEALTHCARE 1364 CLIFTON ROAD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047122000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2018 | ||||||||
| LastUpdateDate: | 07/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.