Individual
DAVID CHRISTIAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 W MAGNETIC ST, MARQUETTE, MI 49855-2711
(906) 225-3561
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD25662
OR
208D00000X
General Practice Physician
Primary
4301089202
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5212533
—
MI
01
—
DG089202
BLUE CROSS
MI
01
—
P00456632
RAILROAD MEDICARE
MI
Enumeration date
09/30/2006
Last updated
04/28/2009
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