Individual
ANDRE GRANT
Active
Individual
ANDRE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2009-01113
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2009-01113
NC
390200000X
Student in an Organized Health Care Education/Training Program
TL-1893
CO
Other
Enumeration date
01/26/2007
Last updated
02/13/2015
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