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Individual
DR. CALVIN ALEXANDER GRANT
Active
Individual
DR. CALVIN ALEXANDER GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036111343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051267
—
IL
05
—
036111343
—
IL
01
—
1679551014
NPI
IL
01
—
205785
PTAN IL MEDICARE COOK COUNTY
IL
01
—
205786
PTAN IL MEDICARE DUPAGE COUNTY
IL
01
—
K47805
PTAN
IL
01
—
P00638025
MEDICARE RAILROAD IL
IL
Enumeration date
01/05/2006
Last updated
12/01/2009
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