Provider Demographics
NPI:1285702431
Name:GRANT, WILLIAM STEVEN (DPM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEVEN
Last Name:GRANT
Suffix:
Gender:M
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:PO BOX 2010
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953
Mailing Address - Country:US
Mailing Address - Phone:740-264-4200
Mailing Address - Fax:740-264-9043
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953
Practice Address - Country:US
Practice Address - Phone:740-264-4200
Practice Address - Fax:740-264-9043
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1846213E00000X
WV168213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0367053Medicaid
OH0367053Medicaid
OH0446741Medicare PIN
T12849Medicare UPIN
OHGR0446741Medicare UPIN
WVGR0446742Medicare PIN
6158830001Medicare NSC
WV0446742Medicare PIN