Provider Demographics
NPI:1134306418
Name:GRISSOM, JOYCE ROTHLEDER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ROTHLEDER
Last Name:GRISSOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 ROCKVILLE PIKE
Mailing Address - Street 2:DEPT OF NEUROLOGY, NNMC
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5600
Mailing Address - Country:US
Mailing Address - Phone:301-295-4770
Mailing Address - Fax:
Practice Address - Street 1:8909 ROCKVILLE PIKE
Practice Address - Street 2:DEPT OF NEUROLOGY, NNMC
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045379L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology