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NPI Code Detail

MEDICARE: DR. TERRY ALAN GRANT M.D.

MEDICARE: DR. TERRY ALAN GRANT M.D.
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
1207P00000XEmergency Medicine Physician39603NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
136802OTHERBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598761892
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY ALAN GRANT M.D.
Provider Business Mailing Address
First Line : 2604 MEDICAL OFFICE PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9417
Country : US
Telephone Number : 919-580-0004
Fax Number : 919-580-9099
Provider Business Practice Location Address
First Line : 2604 MEDICAL OFFICE PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9417
Country : US
Telephone Number : 919-580-0004
Fax Number : 919-580-9099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/05/2024

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