Grant, Michael Thomas

Grant, Michael Thomas is an sole proprietor health care provider with primary practice located at 550 Orchard Park Rd Building B, Suite 105, West Seneca NY 14224-2646. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Grant, Michael Thomas can be contacted via phone (716) 677-6404.

Contact Information

Primary practice address
550 Orchard Park Rd Building B, Suite 105 West Seneca NY 14224-2646
Phone: (716) 677-6404
Fax: (716) 677-6407
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 147528 New York

Profile Details

NPI number 1982694717
LBN Legal business name Grant, Michael Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2005
Last updated Jan 23rd, 2012 - 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 1982694717 NPPES
New York MEDICAID 00886879
New York Other BB1860
New York Other 00010067501
New York Other 0902816
New York Other AA0091
New York Other 000500843001

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