Healthcare Provider Details

I. General information

NPI: 1780374710
Provider Name (Legal Business Name): GRANT STEPHEN OBRIEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6023 HARVARD ST
PITTSBURGH PA
15206-3053
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER- PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-2802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD495539
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: