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General NPI Number Information
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NPI Number | 1902081078
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Entity Type | Organization
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Legal Business Name | PATRICIA R. GRANT, MD PA
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 313B COMMERCE DR
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-6052
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Country | US
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Telephone | 843-894-0978
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Fax | 843-894-1106
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Provider Business Mailing Address
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Address Line | PO BOX 2130
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-2130
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Country | US
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Telephone | 843-894-0978
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Fax | 854-212-7381
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA R GRANT
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Credential | MD
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Telephone | 843-894-0978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 30449
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License Number State | SC
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