Mark Grant, MD

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

018796 Issued in ME

Practice address

489 State St
Bangor, ME 04401-6616

Phone

(207) 973-7000

Fax

(207) 973-5042

NPI assigned

Jan 26, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  NPD
• Mainegeneral Medical Center

  dba MaineGeneral Pharmacy

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1669610960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "address_2": "STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7000",
            "fax_number": "207-973-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "ME",
            "license": "018796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lin Goss, CADC, MHRTC
• Tara Gould, MS, RD
• Brenda Anne Gowesky
• Chelsey Marie Gracia, D.O.
• Harland Thomas Grant III, OTRL
• Michelle Grant, CRNA
• Geoffrey M Gratwick, MD
• Brianna Graves, LCSW
• Courtney Graves, LMFT
• Lucie S Graves, LCPC, LADC

• Trauma Surgery Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Trauma Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.