Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25799 | WV |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 25799 | WV |
NPI | 1629238217 |
---|---|
Provider Name | Dr. Daniel R. Grant |
First Address | Morgantown, WV 26507-0780 |
Second Address | Morgantown, WV 26506-7911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 08/01/2021 |