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Individual

MATTHEW F GRADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S SURGICAL HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104-4319
(215) 590-1527
(215) 590-1501
Mailing address
100 EAST PENN SQUARE, THE WANAMAKER BUILDING 9TH FL, PHILADELPHIA, PA 19107-3323
(267) 425-9538
(267) 425-9552

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C10006565
DE
2080S0010X
Pediatric Sports Medicine Physician
Primary
MD073748L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001901191-0002
PA
Enumeration date
06/29/2006
Last updated
06/03/2016
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