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Individual

GRANT T LIU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE ST, 2 RAVDIN BUILDING, PHILADELPHIA, PA 19104
(215) 662-3606
Mailing address
3400 SPRUCE ST, 3 W. GATES, PHILADELPHIA, PA 19104-4238
(215) 662-3606

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD048699L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014207160003
PA
Enumeration date
07/10/2006
Last updated
07/18/2016
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