Individual
DR. WINDY GUSSIE JOSE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF ADOLESCENT MEDICINE, PHILADELPHIA, PA 19104
(215) 590-7430
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF ADOLESCENT MEDICINE, PHILADELPHIA, PA 19104
(215) 590-7430
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD478834
PA
2080A0000X
Pediatric Adolescent Medicine Physician
MT224851
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2019
Last updated
04/11/2025
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