Individual
STEFAN CHARLES GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1430 TULANE AVE # 8016, NEW ORLEANS, LA 70112-2632
(504) 988-7518
(504) 988-8252
Mailing address
1430 TULANE AVE # 8016, NEW ORLEANS, LA 70112-2632
(504) 988-7518
(504) 988-8252
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
2014-02170
NC
207RH0003X
Hematology & Oncology Physician
30801
AL
207RH0003X
Hematology & Oncology Physician
Primary
335796
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051116824
BCBS
AL
01
—
051116825
BCBS
AL
01
—
051116826
BCBS
AL
01
—
051116827
BCBS
AL
05
—
09003745
—
MS
05
—
128723
—
AL
05
—
128724
—
AL
05
—
128725
—
AL
05
—
128760
—
AL
Enumeration date
04/09/2007
Last updated
06/02/2023
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