MEDICARE: DR. JEWEL T GRANT D.O.

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
1	207V00000X	Obstetrics & Gynecology Physician	66496	GA
2	207V00000X	Obstetrics & Gynecology Physician	OS025596	PA
3	207V00000X	Obstetrics & Gynecology Physician	244204	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1427251461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEWEL T GRANT D.O.

Provider Business Mailing Address
First Line	:	285 BOULEVARD NE STE 120
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-4207
Country	:	US
Telephone Number	:	404-265-2800
Fax Number	:	404-265-2801

Provider Business Practice Location Address
First Line	:	285 BOULEVARD NE STE 120
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-4207
Country	:	US
Telephone Number	:	404-265-2800
Fax Number	:	404-265-2801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	01/29/2026

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Directions to “ DR. JEWEL T GRANT D.O.” Practice Location

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