Healthcare Provider Details

I. General information

NPI: 1366145658
Provider Name (Legal Business Name): GRANT CORVEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 WELLNESS WAY STE B1
FINDLAY OH
45840-9547
US

IV. Provider business mailing address

350 7TH ST N
NAPLES FL
34102-5754
US

V. Phone/Fax

Practice location:
  • Phone: 419-423-5344
  • Fax:
Mailing address:
  • Phone: 239-624-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.018564
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: