Organization
MARC B GRANT DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC B GRANT DO (ADMINISTRATOR/OWNER)
(602) 395-0718
Entity
Organization
Contact information
Practice address
1715 W NORTHERN AVE, SUITE 108, PHOENIX, AZ 85021-5472
(602) 395-0718
(602) 277-8146
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1609
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285280
—
AZ
Enumeration date
07/04/2006
Last updated
05/28/2008
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