Individual
MRS. ILHAM CHERROUK GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(540) 932-4075
(540) 932-5199
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 932-5168
(540) 932-5875
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0101239858
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132TU
BLUE CROSS/BLUE SHIELD
NC
05
—
89132TU
—
NC
Enumeration date
06/10/2005
Last updated
12/20/2023
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