Organization
WOMENS HEALTH HAVEN OBSTETRICS AND GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORRETTE P GRANT MD (PRESIDENT)
(217) 799-1667
Entity
Organization
Contact information
Practice address
2573 RAVENHILL DR, FAYETTEVILLE, NC 28303-5451
(910) 488-7548
(910) 339-0748
Mailing address
PO BOX 1689, ETOWAH, NC 28729-1689
(217) 799-1667
(866) 376-8277
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5912032
—
NC
Enumeration date
07/30/2009
Last updated
10/07/2015
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