Individual
EDWARD M. GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
401 BOTULPH LN, SANTA FE, NM 87505-6912
(505) 983-8387
(505) 820-2733
Mailing address
401 BOTULPH LN, SANTA FE, NM 87505-6912
(505) 983-8387
(505) 820-2733
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2001PA42
NM
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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