Individual
GRANT SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 W MAIN ST STE B, FREEHOLD, NJ 07728-2579
(732) 294-2540
(732) 409-2621
Mailing address
38014 E 113TH ST S, COWETA, OK 74429-3641
(918) 606-4312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34294
OK
Other
Enumeration date
07/20/2015
Last updated
07/02/2019
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