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Individual

DR. SCOTT BRYAN GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M. BIOETHICS

Contact information

Practice address
826 MAIN ST STE 301, PHOENIXVILLE, PA 19460-4459
(610) 983-1028
Mailing address
258 LEVEL RD, COLLEGEVILLE, PA 19426-3453
(248) 259-4548
(888) 372-9871

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
288213
NY
208600000X
Surgery Physician
Primary
MD479667
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0454451
NJ
05
04833309
NY
01
I20150312001346
MEDICARE PECOS
NJ
Enumeration date
07/10/2010
Last updated
12/23/2022
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