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Individual

DR. PHILIP WAYNE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6 TSIENNETO RD STE 100LL, DERRY, NH 03038-1584
(603) 883-4636
(603) 883-6854
Mailing address
PO BOX 291, HUDSON, NH 03051-0291
(603) 883-4636
(603) 883-6854

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
8056
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3072627
NH
Enumeration date
01/05/2006
Last updated
03/28/2022
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