Provider Demographics
NPI:1548629249
Name:GROZAV, ADRIAN G (PHARMD, PHD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:G
Last Name:GROZAV
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6512 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2912
Mailing Address - Country:US
Mailing Address - Phone:216-392-0015
Mailing Address - Fax:
Practice Address - Street 1:6512 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2912
Practice Address - Country:US
Practice Address - Phone:216-392-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist