Individual
FREDERICK DANIEL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, CHILDREN'S HOSPITAL, NUCLEAR MEDICINE, PAVILLION 2, BOSTON, MA 02115-5724
(617) 355-2947
(617) 730-0620
Mailing address
600 S 24TH ST UNIT 405, PHILADELPHIA, PA 19146-1063
(617) 935-5561
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
59705
MA
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
59705
MA
2085P0229X
Pediatric Radiology Physician
MD034356E
PA
2085R0202X
Diagnostic Radiology Physician
MD034356E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3136965
—
MA
Enumeration date
01/08/2007
Last updated
05/01/2024
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