Healthcare Provider Details

I. General information

NPI: 1952352437
Provider Name (Legal Business Name): GRANT P SINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE DEPT OF NEUROSURGERY
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE DEPT OF NEUROSURGERY
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-5400
  • Fax: 414-955-0115
Mailing address:
  • Phone: 414-805-5400
  • Fax: 414-955-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number44102
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: