Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 54975 | KY |
NPI | 1598115073 |
---|---|
Provider Name | Dr. Edmund Michael Grady |
First Address | Louisville, KY 40202-1858 |
Second Address | Louisville, KY 40202-3840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 06/05/2021 |