Individual
DR. ALFRED GRANSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., LLC
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35072595G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142322
ANTHEM BC/BS OF OHIO
OH
05
—
2136683
—
OH
01
—
9387391
MEDICARE GROUP
OH
01
—
DQ1487
RAILROAD MEDICARE INDIVIDUAL
OH
01
—
P00818354
RAILROAD MEDICARE GROUP
OH
Enumeration date
09/25/2006
Last updated
08/04/2011
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