Individual
CHARLES DEAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1933
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1933
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101239660
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010267838
—
VA
Enumeration date
07/13/2006
Last updated
10/28/2014
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