Individual
ROBERT GRANT WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(334) 590-0762
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(334) 590-0762
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
226854
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
93092
SC
Other
Enumeration date
04/11/2017
Last updated
08/20/2024
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