Individual
MICHELLE LEEANN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
OS017402
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2010
Last updated
08/31/2020
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