Individual
PAUL R. GRANZOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
181 DANIEL RD, FOREST CITY, NC 28043-7151
(828) 286-9036
(828) 286-1079
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(828) 286-9036
(828) 286-1079
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101884
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104908748
—
NC
05
—
8101814
—
NC
01
—
970027367
MEDICARE RAILROAD
—
Enumeration date
10/20/2006
Last updated
08/31/2016
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