Bradley P Grant MD PA

NPI #1083894125 in W Melbourne, Florida

Provider Information

NPI Number: 1083894125
Entity Type: Organization
Organization Name: Bradley P Grant MD PA
Primary Specialty: Specialist
Enumeration Date: Nov 6, 2007
Last Updated: Jun 26, 2008

Practice Location

Address: 1480 S WICKHAM RD
City: W Melbourne
State: Florida
ZIP Code: 32904-2447
Phone: (321) 724-2188

Authorized Official

Name: DR. BRADLEY P GRANT, MD
Title: OWNER
Phone: (321) 724-2188

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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