Individual
DR. MICHAEL EDWARD GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,PHD
Contact information
Practice address
3890 PHEASANT RIDGE DR NE, BLAINE, MN 55449-5854
(763) 792-9507
(763) 792-9514
Mailing address
3890 PHEASANT RIDGE DR NE, BLAINE, MN 55449-5854
(763) 792-9507
(763) 792-9514
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
502209
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
502209
BOARD OF PHARMANCY LICENSE
MN
Enumeration date
08/25/2010
Last updated
03/07/2023
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