Grantham, Dale Courtney

Grantham, Dale Courtney is an individual health care provider with primary practice located at 1110 Blue Sage Rd Ne , Rio Rancho NM 87144-5763. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Grantham, Dale Courtney can be contacted via phone (509) 942-4793.

Contact Information

Primary practice address
1110 Blue Sage Rd Ne Rio Rancho NM 87144-5763
Phone: (509) 942-4793
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00041473 Washington
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD2012-0049193 New Mexico
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X MD2012-0049193 New Mexico

Profile Details

NPI number 1932140456
LBN Legal business name Grantham, Dale Courtney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated May 30th, 2023 - about last year

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 1932140456 NPPES
Washington MEDICAID 8317067
Washington Other 3075GR
Washington Other 605960008
Washington Other 0202687

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