MEDICARE: ANNE SENIOW GRANTHAM M.D.

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	207Q00000X	Family Medicine Physician	35058863	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080175930	OTHER	OH	RAILROAD MEDICARE

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

General Provider Information

NPI Number	:	1992791016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE SENIOW GRANTHAM M.D.

Provider Business Mailing Address
First Line	:	1587 BOETTLER RD STE 110
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7823
Country	:	US
Telephone Number	:	330-896-3033
Fax Number	:	330-896-5692

Provider Business Practice Location Address
First Line	:	571 E TURKEYFOOT LAKE RD
Second Line	:	SUITE A
City	:	AKRON
State	:	OH
Zip	:	44319-4122
Country	:	US
Telephone Number	:	330-896-3033
Fax Number	:	330-896-5692

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	02/13/2019

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Directions to “ ANNE SENIOW GRANTHAM M.D.” Practice Location

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