Individual provider · Type 1 NPI

Brian E. Granvall, PA-C

Diagnostic Radiology Physician · Boise, ID

NPI number 1205809852 Active

Practice location

190 E Bannock St
Boise, ID 83712-6241

Call (208) 381-2094 Map

Fax (208) 381-1791

Mailing address

PO Box 1108
Corvallis, OR 97339-1108

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0110002940 (VA)
Physician Assistant 363A00000XPA10004399 (WA)
Physician Assistant 363A00000XPA 00846 (OR)
Surgical Physician Assistant 363AS0400XC04233 (MD)
Diagnostic Radiology Physician Primary 2085R0202XPA-1042 (ID)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1205809852

Brian E. Granvall, PA-C's National Provider Identifier is 1205809852, issued on Feb 13, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Boise, ID. The record was last updated on Jan 31, 2022.