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Individual

DR. GRANTHAM DEWITT WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
853 N CHURCH ST, SUITE 600, SPARTANBURG, SC 29303-3098
(864) 583-4556
(864) 560-0625
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
26613
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
195791
MEDCOST
SC
05
266198
SC
01
7981583
AETNA
SC
05
89067EE
NC
Enumeration date
01/23/2006
Last updated
01/14/2021
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