Individual
MATTHEW WILLIAM GRANGE
Active
Individual
MATTHEW WILLIAM GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3020000
MN
152WC0802X
Corneal and Contact Management Optometrist
3020000
MN
152WP0200X
Pediatric Optometrist
3020000
MN
152WS0006X
Sports Vision Optometrist
3020000
MN
152WX0102X
Occupational Vision Optometrist
Primary
3020000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182595
UCARE
MN
01
—
2203255
MEDICA
MN
01
—
2425242
AMERICAS PPO
—
01
—
86G79GR
BLUE CROSS BLUE SHIELD
MN
01
—
HP60833
HEALTH PARTNERS
MN
01
—
XX1901044875
PREFERRED ONE
MN
Enumeration date
10/10/2006
Last updated
09/11/2025
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