Granada, Mark John

Granada, Mark John is an individual health care provider with primary practice located at 9109 Middleford Road , Seaford DE 19973. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Granada, Mark John can be contacted via phone (302) 629-9483.

Contact Information

Primary practice address
9109 Middleford Road Seaford DE 19973
Fax: (302) 628-3977
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X CI0001675 Delaware
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C1-0001675 Delaware

Profile Details

NPI number 1275696718
LBN Legal business name Granada, Mark John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Nov 29th, 2011 - about 13 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 1275696718 NPPES
Delaware MEDICAID 000128601

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