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Individual

GRANT W HUNTZINGER

Active
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Individual

GRANT W HUNTZINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
022420
GA
2085R0202X
Diagnostic Radiology Physician
Primary
MD11568
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000248476
GA
01
151364
BCBS OF GA
GA
05
3805918
TN
01
4073000
BCBS OF TN
TN
01
44770
BCBS OF TN
TN
01
511425
BCBS OF GA
GA
Enumeration date
07/21/2006
Last updated
02/22/2018
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