Individual
DR. WILLIAM T GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
908 E JEFFERSON ST, SUITE 101, CHARLOTTESVILLE, VA 22902-5375
(434) 817-7200
(434) 817-7205
Mailing address
908 E JEFFERSON ST, SUITE 101, CHARLOTTESVILLE, VA 22902-5375
(434) 817-7200
(434) 817-7205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101036663
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14105
OPTIMA HEALTH
VA
01
—
146381
SOUTHERN HEALTH
VA
01
—
284735
ANTHEM
VA
01
—
3502513
CIGNA
VA
01
—
367116
MAMSI
VA
05
—
6401082
—
VA
01
—
H0672
RR MEDICARE - GRP NUMBER
VA
Enumeration date
05/23/2005
Last updated
08/28/2012
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