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Individual

DR. DAVID SAMUEL GRANITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7500 HANOVER PKWY STE 206, GREENBELT, MD 20770-2009
(301) 474-2141
(301) 345-3874
Mailing address
7500 HANOVER PKWY STE 206, GREENBELT, MD 20770-2009
(301) 474-2141
(301) 345-3874

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0017572
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080137996
MEDICARE RR
MD
01
1031290
AFFORDABLE/1ST HEALTH
MD
01
18061012
UNITED HEALTH
MD
01
246432
MAMSI
MD
05
302151300
MD
01
4051960
AETNA PPO
MD
01
41447001
BCBS OF MD
MD
01
522040780
PHCS
MD
01
60370006
BCBS OF NATL CAP
MD
01
735966
AETNA HMO
MD
01
7975077
CIGNA
MD
Enumeration date
07/22/2005
Last updated
09/24/2014
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