Anciano Granadillo, Carlos Jose

Anciano Granadillo, Carlos Jose is an sole proprietor health care provider with primary practice located at 115 Heart Dr , Greenville NC 27834-8982. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Anciano Granadillo, Carlos Jose can be contacted via phone (252) 744-4400.

Contact Information

Primary practice address
115 Heart Dr Greenville NC 27834-8982
Phone: (252) 744-4400
Fax: (252) 744-3987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2013-01958 North Carolina
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 2013-01958 North Carolina

Profile Details

NPI number 1154563906
LBN Legal business name Anciano Granadillo, Carlos Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2009
Last updated Jan 24th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154563906 NPPES
North Carolina MEDICAID 1154563906
North Carolina Other 184R0

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