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General NPI Number Information
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NPI Number | 1831247204
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Entity Type | Individual
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Provider Name | FREDERICK DANIEL GRANT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 300 LONGWOOD AVE CHILDREN'S HOSPITAL, NUCLEAR MEDICINE, PAVILLION 2
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-2947
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Fax | 617-730-0620
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Provider Business Mailing Address
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Address Line | 600 S 24TH ST UNIT 405
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1063
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Country | US
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Telephone | 617-935-5561
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Fax |
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 59705
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD034356E
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD034356E
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 59705
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License Number State | MA
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