Individual
MR. LEROY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIANS ASSISTANT
Contact information
Practice address
12215 DALEWOOD DR, SILVER SPRING, MD 20902-1119
(301) 946-0806
(301) 946-0806
Mailing address
12215 DALEWOOD DR, SILVER SPRING, MD 20902-1119
(301) 946-0806
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA165
DC
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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