Individual
SHEREENE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 S MADISON ST, MUNCIE, IN 47305
(765) 286-7000
(765) 213-2769
Mailing address
333 S MADISON ST, MUNCIE, IN 47305-2465
(765) 286-7000
(765) 213-2769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01080578A
IN
207Q00000X
Family Medicine Physician
35.132739
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148362
—
OH
Enumeration date
04/14/2015
Last updated
07/10/2018
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