Organization
DR RICHARD L GRANT P L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD L GRANT D.P.M. (PODIATRIST)
(248) 545-0100
Entity
Organization
Contact information
Practice address
27901 WOODWARD AVE, SUITE 110, BERKLEY, MI 48072-0919
(248) 545-0100
(248) 545-1285
Mailing address
581 FOX POINTE CT, BLOOMFIELD HILLS, MI 48304-1813
(248) 334-9162
(248) 334-2114
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901000735
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4418408
—
MI
01
—
4856353590
BCBSM
MI
Enumeration date
05/08/2007
Last updated
05/19/2008
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