Individual
MICHAEL P GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3363
(434) 924-5078
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101285693
VA
207W00000X
Ophthalmology Physician
D50361
MD
208200000X
Plastic Surgery Physician
Primary
0101285693
VA
208200000X
Plastic Surgery Physician
D50361
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368050900
—
MD
Enumeration date
04/18/2006
Last updated
06/16/2025
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