Provider Demographics
NPI:1780733378
Name:GRANT, DUNCAN M (DPM)
Entity type:Individual
Prefix:
First Name:DUNCAN
Middle Name:M
Last Name:GRANT
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 142ND AVE N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2822
Mailing Address - Country:US
Mailing Address - Phone:727-796-6900
Mailing Address - Fax:727-669-8417
Practice Address - Street 1:508 MEETING ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7535
Practice Address - Country:US
Practice Address - Phone:727-796-6900
Practice Address - Fax:727-669-8417
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002229213E00000X
OH36.002229213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0559088Medicaid
OH0559088Medicaid