Grantham, Mica Dianna

Grantham, Mica Dianna is an individual health care provider with primary practice located at 2041 Georgia Avenue, Nw 1M05, Washington DC 20060-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Grantham, Mica Dianna can be contacted via phone (202) 865-1354.

Contact Information

Primary practice address
2041 Georgia Avenue, Nw 1M05 Washington DC 20060-0001
Phone: (202) 865-1354
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X C1-0011207 Delaware
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD453773 Pennsylvania
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD210002279 District of Columbia

Profile Details

NPI number 1336433390
LBN Legal business name Grantham, Mica Dianna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2011
Last updated Feb 2nd, 2023 - about 3 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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