Granda, Antonio M
Granda, Antonio M is an individual health care provider with primary practice located at 46 Fairview Ave Ste 221 , Skowhegan ME 04976-1481. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Granda, Antonio M can be contacted via phone (207) 474-6945.Contact Information
Primary practice address
46 Fairview Ave Ste 221
Skowhegan ME 04976-1481
Phone: (207) 474-6945
Fax: (207) 474-6933
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 09565 | Tennessee |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 35.143494 | Ohio |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 9565 | Tennessee |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | MD23009 | Maine |
Profile Details
| NPI number | 1780624023 |
|---|---|
| LBN Legal business name | Granda, Antonio M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Nov 4th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780624023 | NPPES |
| Tennessee | Other | 3164315 | BLUE CROSS OF TN |
| Tennessee | MEDICAID | 64746449 | BLUE CROSS OF TN |
| Tennessee | Other | 104697 | BLUE CROSS OF TN |
| Tennessee | Other | 378643 | BLUE CROSS OF TN |
| Tennessee | MEDICAID | Q006396 | BLUE CROSS OF TN |
| Tennessee | Other | 10074063 | BLUE CROSS OF TN |
| Tennessee | Other | 1416751 | BLUE CROSS OF TN |
| Tennessee | MEDICAID | 1507235 | BLUE CROSS OF TN |
| Tennessee | Other | 1629728 | BLUE CROSS OF TN |
| Tennessee | Other | 4066743 | BLUE CROSS OF TN |
| Tennessee | Other | 1100315241 | BLUE CROSS OF TN |
| Tennessee | Other | 12079645 | BLUE CROSS OF TN |
| Tennessee | Other | 100014907 | BLUE CROSS OF TN |
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