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Individual
EILEEN C DE GRANDIS
Active
Individual
EILEEN C DE GRANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
52974
MN
2086S0129X
Vascular Surgery Physician
Primary
ME127513
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
07/23/2009
Last updated
06/03/2021
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