Individual
GRANT OAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 CONGRESS ST STE B, PORTLAND, ME 04102-2148
(207) 774-5222
Mailing address
1600 CONGRESS ST STE B, PORTLAND, ME 04102-2148
(207) 774-5222
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
DO3180
ME
390200000X
Student in an Organized Health Care Education/Training Program
218471
NC
Other
Enumeration date
04/18/2016
Last updated
08/03/2021
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