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Individual

ARNOLD STEPHAN GRANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2011

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
22344
NC
207VM0101X
Maternal & Fetal Medicine Physician
Primary
22344
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24532
MEDCOST
NC
01
3601
PARTNERS MEDICARE CHOICE
NC
01
36720
BCBS NC
NC
01
4315329
AETNA
NC
05
8936720
NC
Enumeration date
05/26/2006
Last updated
06/24/2014
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