Individual
DR. NATHAN GRANT HAVERSTICK
Active
Individual
DR. NATHAN GRANT HAVERSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13703
GA
207RI0200X
Infectious Disease Physician
Primary
UO10377
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13703
GEORGIA COMPOSITE MEDICAL BOARD
GA
01
—
UO10377
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
03/22/2021
Last updated
06/18/2025
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