Individual
DR. CLARICE GRANDPRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
995 ELLESMERE DR, FAIRBANKS, AK 99709-5759
(907) 479-8101
Mailing address
PO BOX 84945, FAIRBANKS, AK 99708-4945
(907) 374-4463
(907) 374-7072
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2983
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD0102
—
AK
Enumeration date
02/20/2006
Last updated
08/28/2019
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