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General NPI Number Information
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NPI Number | 1063692929
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Entity Type | Organization
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Legal Business Name | GRANT J. ANHALT, MD, LLC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 7401 OSLER DR SUITE 107
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City | BALTIMORE
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State | MD
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Zip | 21204-7673
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Country | US
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Telephone | 410-321-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 OSLER DR SUITE 107
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City | BALTIMORE
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State | MD
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Zip | 21204-7673
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Country | US
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Telephone | 410-321-5900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GRANT J ANHALT
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Credential | M.D.
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Telephone | 410-321-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D28241
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License Number State | MD
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