Individual
RICHARD E GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7900
(215) 456-5948
Mailing address
5501 OLD YORK ROAD, WILLOWCREST 4TH FLOOR, PHILADELPHIA, PA 19141
(215) 456-7900
(215) 456-3428
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35-052114
OH
207X00000X
Orthopaedic Surgery Physician
Primary
MD445476
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221326
UNISON
OH
01
—
000000503677
ANTHEM
OH
05
—
2610339
—
OH
01
—
363580
WELLCARE
OH
01
—
4311723
AETNA
OH
01
—
738057
BUCKEYE
OH
01
—
P00358792
RAILROAD MEDICARE
OH
Enumeration date
07/18/2006
Last updated
03/08/2017
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