Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 26825 | NC |
N | 2080P0202X | Pediatric Cardiologist | 26825 | NC |
NPI | 1154315893 |
---|---|
Provider Name | James W Grant |
First Address | Rocky Mount, NC 27804-0200 |
Second Address | Rocky Mount, NC 27804-9590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 08/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1563457 | CIGNA HEALTHCARE (01) | NC |
259126 | UNITED HEALTH CARE (01) | NC |
36770 | BCBSNC (01) | NC |
370007244 | RAILROAD MEDICARE (01) | NC |
5541070 | AETNA (01) | NC |
66487 | MEDCOST (01) | NC |
7936770 | (05) | NC |
E58593 | (02) | NC |