Individual
COURTNEY L GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0116025753
VA
208600000X
Surgery Physician
86237
GA
2086S0129X
Vascular Surgery Physician
Primary
86237
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003235364A
—
GA
05
—
003235364B
—
GA
05
—
003235364C
—
GA
05
—
003235364D
—
GA
05
—
003235364E
—
GA
05
—
003235364F
—
GA
05
—
003235364G
—
GA
05
—
003235364H
—
GA
Enumeration date
06/07/2013
Last updated
02/07/2022
Update your record
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