Individual
DR. MATTHEW J GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-5386
(319) 235-3074
Mailing address
PO BOX 2758, 4150 KIMBALL AVE, WATERLOO, IA 50704-2758
(319) 235-5390
(319) 233-1630
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
38227
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982813739
—
IA
01
—
421417307V1
UHC/RIVER VALLEY/JD PREMIER
IA
Enumeration date
05/21/2007
Last updated
04/10/2014
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