MARK GRANT (NPI# 1669610960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669610960 |
| Entity Type | Individual |
| Full Name | MARK GRANT |
| Credential | MD |
| Practice Address |
489 State St Bangor ME 04401-6616 |
| Mailing Address |
43 Whiting Hill Rd Ste 300 Brewer ME 04412-1005 |
| Practice Telephone | 2079737000 |
| Practice Fax Number | 2079735042 |
| Mailing Telephone | 2079735035 |
| Mailing Fax Number | 2079735042 |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2019-03-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
018796 | ME | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417016668 | Mark Timothy Grant | Chiropractor | 803 Powder Springs St Ste 10, Marietta, GA 30064-3649 | 2006-12-06 |
| 1477016921 | Mark Austin Grant | Family Medicine | 3950 S Country Club Rd Ste 130, Tucson, AZ 85714-2203 | 2019-04-11 |
| 1306357041 | Mark Elias Grant | Occupational Therapist | 33330 8th Ave S, Federal Way, WA 98003-6325 | 2017-10-21 |
| 1316219546 | Mark Grant | Family Medicine | 225 N Michigan Ave, Bcbsa, Chicago, IL 60601-7757 | 2012-02-03 |
| 1922339050 | Mark Cullen Grant | Dentist | 4613 W Orem Dr, Houston, TX 77045-4107 | 2010-01-29 |
| 1477730141 | Mark Charles Grant | Chiropractor | 451 Pine Lake Ave, La Porte, IN 46350-2314 | 2008-01-24 |
| 1225079510 | Mark Grant | Emergency Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-06-09 |
| Street Address |
489 STATE ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789147 | Eastern Maine Medical Center | General Acute Care Hospital | 489 State St, Bangor, ME 04401-6616 | 2005-06-13 |
| 1356956239 | Amanda Roberts | Physician Assistant | 489 State St, Bangor, ME 04401-6674 | 2020-09-09 |
| 1558983148 | Lana Caroline Hoertz | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2020-05-18 |
| 1427696954 | Kelsey A Mcgrath | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-12-16 |
| 1528629888 | Jaclyn Young | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-06-26 |
| 1568928018 | Emily Bohm | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-20 |
| 1144786971 | Andrew Hopkins | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-18 |
| 1750847083 | Daniel Patrick Conway | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-12 |
| 1306317847 | Matthew Daniel Kent | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2018-12-10 |
| 1750869061 | Brian Marsh | Nurse Practitioner | 489 State St, Bangor, ME 04401 | 2018-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023351368 | Thomas Paul Nowakowski | Surgery | 417 State St Ste 340, Bangor, ME 04401-6634 | 2013-04-05 |
| 1942443627 | Sasha Sotirovic | Surgery | 489 State St, Bangor, ME 04401-6616 | 2009-04-11 |
| 1770775421 | Rony J Ramia | Surgery | 489 State St, Bangor, ME 04401-6616 | 2007-08-16 |
| 1881894012 | Amy Teresa Fenwick | Surgery | 489 State St, Bangor, ME 04401-6616 | 2007-07-25 |
| 1790711430 | Rafael J Grossmann | Surgery | 489 State St, Bangor, ME 04401-6616 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730470477 | Chiajung Karen Lu | Surgery | 12 High St Ste 401, Lewiston, ME 04240-7690 | 2011-04-28 |
| 1285738310 | Maine Medical Partners | Surgery | 887 Congress St, Suite 210, Portland, ME 04102-3100 | 2006-09-11 |
| 1649389677 | Bruce Chung | Surgery | 887 Congress St, Portland, ME 04102-3100 | 2006-08-30 |
| 1801803523 | Sanjay Gupta | Surgery | 12 High St, Ste 401, Lewiston, ME 04240-7676 | 2006-08-02 |
| 1033130612 | David J Burke | Surgery | 12 High St, Ste. 401, Lewiston, ME 04240-7676 | 2006-07-21 |
| 1346229077 | Larry O Hopperstead | Surgery | 12 High St, Ste 401, Lewiston, ME 04240-7634 | 2006-01-11 |
Please comment or provide details below to improve the information on MARK GRANT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.