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NPI Code Detail

MEDICARE: ROBERT W GRANT PHD

MEDICARE: ROBERT W GRANT PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist00990IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043397243
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W GRANT PHD
Provider Business Mailing Address
First Line : 411 OAK ST
Second Line : STERLING MEDICAL ASSOCIATES, ATTN: CREDENTIALS
City : CINCINNATI
State : OH
Zip : 45219-2504
Country : US
Telephone Number : 513-984-1800
Fax Number : 513-984-4909
Provider Business Practice Location Address
First Line : 411 OAK ST
Second Line : STERLING MEDICAL ASSOCIATES
City : CINCINNATI
State : OH
Zip : 45219-2504
Country : US
Telephone Number : 513-984-1800
Fax Number : 513-984-4909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 11/18/2008

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