Provider Demographics
NPI:1477908515
Name:SIMPSON GRANT, DESIREE (MD)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:SIMPSON GRANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 HILLPOINT BLVD N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-7181
Mailing Address - Country:US
Mailing Address - Phone:757-539-3911
Mailing Address - Fax:
Practice Address - Street 1:2050 HILLPOINT BLVD N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-7181
Practice Address - Country:US
Practice Address - Phone:757-539-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282712207V00000X
NY302888207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology