Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 248050 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 248050 | MA |
NPI | 1609034230 |
---|---|
Provider Name | Edward Wilson Grandin |
First Address | Boston, MA 02215-5324 |
Second Address | Boston, MA 02215-5324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 10/10/2017 |