Individual
WALTER GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
480 FLOYD RD, SPARTANBURG, SC 29307-1518
(864) 582-2115
(864) 582-2117
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
504
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005041
—
SC
01
—
P01045397
RAILROAD MEDICARE
SC
Enumeration date
07/11/2005
Last updated
01/12/2021
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