Grant, Sandra Rue

Grant, Sandra Rue is an individual health care provider with primary practice located at 1501 Kings Highway Department Of Pediatrics/Neonatology, Shreveport LA 71103-4228. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is her primary health care specialty. Grant, Sandra Rue can be contacted via phone (318) 675-7880.

Contact Information

Primary practice address
1501 Kings Highway Department Of Pediatrics/Neonatology Shreveport LA 71103-4228
Phone: (318) 675-7880
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD.06216R Louisiana
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X MD.06216R Louisiana

Profile Details

NPI number 1639192685
LBN Legal business name Grant, Sandra Rue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Mar 21st, 2018 - about 8 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 1639192685 NPPES
Louisiana MEDICAID 1343838

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