Individual
MR. JEFFREY S GRANDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-0554
Mailing address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
(207) 773-1489
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02529
NC
363A00000X
Physician Assistant
0110008498
VA
Other
Enumeration date
10/04/2006
Last updated
02/06/2024
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