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Grigoriy Tsotneevich Rodonaia, M.D. PA

Family Medicine in Beaumont, TX. Individual provider (NPI-1).

NPI number1023210317
StatusActive
Last updated in NPPESFeb 19, 2010

Details

NPI
1023210317
Entity type
Individual (NPI-1)
Name
Grigoriy Tsotneevich Rodonaia
Credential
M.D. PA
Sex
Male
Sole proprietor
Yes
Enumeration date
May 31, 2007
Last updated
Feb 19, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineM6986TXYes

Practice location

2955 Harrison St
Ste. 200
Beaumont, TX 77702-1154

Phone 409-923-1617 · Fax 409-923-1618

Mailing address

2955 Harrison St
Ste. 200
Beaumont, TX 77702-1154

Phone 409-923-1617 · Fax 409-923-1618

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