NPI 1003862939

Phillip D Granger, PAC

Practitioner Physician Assistant Virginia Beach, VA

Practice location

Address: 3432 Holland Rd, Virginia Beach, VA 23452-4846
Phone: (757) 468-1855
Mailing address: 5000 Cox Rd, Glen Allen, VA 23060-9263

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 0110001146 (VA)

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Registry record

NPI: 1003862939
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 May 2006
Record last updated: 23 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.