Provider Demographics
NPI:1811906993
Name:GRANT, MICHAEL DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DANIEL
Last Name:GRANT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3900 JUNIUS STREET
Mailing Address - Street 2:SUITE 222
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246
Mailing Address - Country:US
Mailing Address - Phone:214-826-7300
Mailing Address - Fax:214-827-7032
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2029
Practice Address - Country:US
Practice Address - Phone:214-826-7300
Practice Address - Fax:214-827-7032
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2014-06-16
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Provider Licenses
StateLicense IDTaxonomies
TXH43582086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE77096Medicare UPIN
TX0007BAMedicare ID - Type Unspecified