Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 260787 | NC |
NPI | 1013545417 |
---|---|
Provider Name | Grant Blanchard |
First Address | New Orleans, LA 70115-3839 |
Second Address | Charlotte, NC 28207-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2020 |
Last Update Date | 31/03/2020 |