Individual
STANLEY CHASE GRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15212 MICHIGAN AVE, DEARBORN, MI 48126-3497
(313) 582-8856
(313) 582-8265
Mailing address
15212 MICHIGAN AVE, DEARBORN, MI 48126-3497
(313) 582-8856
(313) 582-8265
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
SG030076
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1382517
—
MI
Enumeration date
06/06/2006
Last updated
10/15/2007
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