Individual
DR. DAVID WAYNE GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 FIRST VILLAGE DRIVE, PINEHURST, NC 28374-2000
(910) 295-6831
(910) 295-0244
Mailing address
5 FIRSTVILLAGE DRIVE, PO BOX 2000, PINEHURST, NC 28374
(910) 295-6831
(910) 295-0244
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2007-01020
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145NY
BCBS
—
05
—
1689871683
—
VA
01
—
199308
MEDCOST
—
05
—
3810009398
—
WV
05
—
5907193
—
NC
01
—
7263977
AETNA
—
01
—
810125
PARTNERS
—
05
—
Q20007
—
SC
Enumeration date
07/02/2007
Last updated
09/10/2018
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