Individual
PAUL M GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2861 TRICOM ST, N CHARLESTON, SC 29406-9172
(843) 797-5511
Mailing address
2861 TRICOM ST, N CHARLESTON, SC 29406-9172
(843) 797-5511
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
7647
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076474
—
SC
01
—
1760598007
NPI
—
01
—
180034151
RAILROAD MEDICARE
SC
Enumeration date
08/21/2006
Last updated
10/06/2009
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