Individual
DR. CHARLES THOMAS GRAD SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 SMALLACOMBE DR, SCRANTON, PA 18508-2616
(570) 961-0171
(570) 207-2411
Mailing address
5 STONYBROOK RD, CLARKS SUMMIT, PA 18411-1166
(570) 586-9578
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD014268E
PA
207RG0100X
Gastroenterology Physician
MD014268E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006769880001
—
PA
01
—
MD014268E
MD LICENSE
PA
Enumeration date
08/03/2006
Last updated
09/11/2025
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