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Individual
DR. GRANTHAM DEWITT WARREN
Active
Individual
DR. GRANTHAM DEWITT WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
26613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
195791
MEDCOST
SC
05
—
266198
—
SC
01
—
7981583
AETNA
SC
05
—
89067EE
—
NC
Enumeration date
01/23/2006
Last updated
01/14/2021
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