MEDICARE: DR. ANGELA GRENANDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	6330	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	404269	OTHER		TUFTS
3	71004910	OTHER		CIGNA
4	RI6330	OTHER	RI	MEDICAL LIC
5	1200164	OTHER		UNITED HEALTH CARE
6	22767	OTHER		BLUE CROSS
7	202233	OTHER		BLUE CHIP

General Provider Information

NPI Number	:	1851386189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA GRENANDER MD

Provider Business Mailing Address
First Line	:	234 MAPLE AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3406
Country	:	US
Telephone Number	:	401-247-1644
Fax Number	:	401-247-4961

Provider Business Practice Location Address
First Line	:	234 MAPLE AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3406
Country	:	US
Telephone Number	:	401-247-1644
Fax Number	:	401-247-4961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	03/07/2023

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