Individual
ALEXANDER GRANTSARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4289
Mailing address
3662 KINGSWAY DR, CROWN POINT, IN 46307-8936
(219) 308-8041
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
115857
MT
363LF0000X
Family Nurse Practitioner
Primary
28197039A
IN
Other
Enumeration date
08/31/2016
Last updated
08/22/2019
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