Provider Demographics
NPI:1376074849
Name:HUISH, GRANT ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:ANDREW
Last Name:HUISH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19646 N 27TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4026
Mailing Address - Country:US
Mailing Address - Phone:602-663-9371
Mailing Address - Fax:602-456-6887
Practice Address - Street 1:19646 N 27TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4026
Practice Address - Country:US
Practice Address - Phone:602-663-9371
Practice Address - Fax:602-456-6887
Is Sole Proprietor?:No
Enumeration Date:2017-03-25
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ010750208600000X
OH34.015780208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery