Provider Demographics
NPI:1881655819
Name:GRADE, ANDREW J (MD)
Entity Type:Individual
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First Name:ANDREW
Middle Name:J
Last Name:GRADE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3020 E CAMELBACK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4418
Mailing Address - Country:US
Mailing Address - Phone:602-264-9100
Mailing Address - Fax:602-264-9101
Practice Address - Street 1:603 W BASELINE RD STE 200
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6047
Practice Address - Country:US
Practice Address - Phone:480-461-1088
Practice Address - Fax:480-461-1657
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
AZ21999207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF72563Medicare UPIN