Individual
DIAN PATRICIA GRANDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5452
(410) 550-0539
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F341403-1
NY
207Q00000X
Family Medicine Physician
Primary
R238234
MD
Other
Enumeration date
07/21/2017
Last updated
05/06/2021
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