Individual
DR. KEVIN E GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13164 N. TOWN RIDGE RD, BOISE, ID 83714
(916) 989-6400
(916) 635-8047
Mailing address
1004 RIVER ROCK #131, #131, FOLSOM, CA 95630-2095
(916) 989-6400
(916) 635-8047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MV-0025
ID
Other
Enumeration date
07/18/2006
Last updated
08/26/2023
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