Provider Demographics
NPI:1558628818
Name:GRIMSLEY ACKERLEY, CASSIE MARIE (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:MARIE
Last Name:GRIMSLEY ACKERLEY
Suffix:
Gender:F
Credentials:MD, MSC
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Mailing Address - Street 1:3131 N DRUID HILLS RD APT 10103
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3131 N DRUID HILLS RD APT 10103
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2663
Practice Address - Country:US
Practice Address - Phone:706-414-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA767242080P0208X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious DiseasesGroup - Single Specialty