Provider Demographics
NPI:1033372578
Name:GRINAGE, BRANDON CY (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:CY
Last Name:GRINAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 POWERS FERRY RD SE STE 120
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-9401
Mailing Address - Country:US
Mailing Address - Phone:770-580-0979
Mailing Address - Fax:678-383-6735
Practice Address - Street 1:1545 POWERS FERRY RD SE STE 120
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-9401
Practice Address - Country:US
Practice Address - Phone:770-580-0979
Practice Address - Fax:678-383-6735
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL31143208600000X
GA068419207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery