Individual
DR. JUAN LUIS GRANADOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE, SUITE 306 - OB/GYN, RALEIGH, NC 27610-1247
(919) 350-8535
(919) 350-8310
Mailing address
3024 NEW BERN AVE, SUITE 300, RALEIGH, NC 27610-1247
(919) 350-8228
(919) 350-7976
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
30912
NC
207VM0101X
Maternal & Fetal Medicine Physician
Primary
30912
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8936704
—
NC
Enumeration date
08/09/2006
Last updated
02/06/2012
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