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General NPI Number Information
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NPI Number | 1629538392
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Entity Type | Individual
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Provider Name | GRANT THOMAS DUVALL
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 201 E UNIVERSITY PKWY DEPT OF
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City | BALTIMORE
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State | MD
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Zip | 21218-2829
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Country | US
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Telephone | 410-554-2857
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Fax | 410-554-4326
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Provider Business Mailing Address
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Address Line | 201 E UNIVERSITY PKWY DEPT OF
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City | BALTIMORE
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State | MD
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Zip | 21218-2829
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Country | US
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Telephone | 410-554-2857
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Fax | 410-554-4326
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | D0103694
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License Number State | MD
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