Individual
JUAN ROBERT GRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2171
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0010-04725
NC
363A00000X
Physician Assistant
Primary
0010-04725
NC
Other
Enumeration date
01/23/2014
Last updated
09/29/2022
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