Provider Demographics
NPI:1336173103
Name:DE GRAUW, TON J (MD)
Entity Type:Individual
Prefix:
First Name:TON
Middle Name:J
Last Name:DE GRAUW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2015 UPPERGATE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-712-9460
Mailing Address - Fax:404-727-1981
Practice Address - Street 1:2015 UPPERGATE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-712-9460
Practice Address - Fax:404-727-1981
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-08-17
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Provider Licenses
StateLicense IDTaxonomies
GA0666872084N0402X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology