Individual
RICHARD L. GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
139 WATERLOO ST SW, AIKEN, SC 29801-3756
(803) 642-1000
(803) 642-0036
Mailing address
139 WATERLOO ST SW, PO BOX 2171, AIKEN, SC 29801-3771
(803) 642-1000
(803) 642-0036
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16513
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1593
—
SC
Enumeration date
10/25/2006
Last updated
04/11/2008
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