Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301097422 | MI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4301097422 | MI |
NPI | 1073820908 |
---|---|
Provider Name | John A Grant |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2010 |
Last Update Date | 21/07/2014 |