Individual ProviderDavid Samuel GraniteFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address7500 Hanover Pkwy Ste 206, Greenbelt, MD 20770-2009(301) 474-2141PECOS EnrollmentBased on the most recent information from CMS, provider David Samuel Granite does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1508866229Provider TypeIndividualFull NameGranite, David SamuelTitleDr.CredentialM.D.GenderMaleSole ProprietorYesEnumeration Date7/22/2005Last Updated9/24/2014Contact InformationPractice LocationPractice Address7500 Hanover Pkwy Ste 206, Greenbelt, MD 20770-2009Phone(301) 474-2141Fax(301) 345-3874Mailing LocationMailing Address7500 Hanover Pkwy Ste 206, Greenbelt, MD 20770-2009Phone(301) 474-2141Fax(301) 345-3874Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseD0017572MarylandProvider IdentifiersIDDescriptionIssuerID60370006DescriptionOtherIssuerBCBS OF NATL CAPMarylandID1031290DescriptionOtherIssuerAFFORDABLE/1ST HEALTHMarylandID4051960DescriptionOtherIssuerAETNA PPOMarylandID41447001DescriptionOtherIssuerBCBS OF MDMarylandID522040780DescriptionOtherIssuerPHCSMarylandID7975077DescriptionOtherIssuerCIGNAMarylandID246432DescriptionOtherIssuerMAMSIMarylandID522040780DescriptionOtherIssuerONE HEALTHMarylandID080137996DescriptionOtherIssuerMEDICARE RRMarylandID735966DescriptionOtherIssuerAETNA HMOMarylandID18061012DescriptionOtherIssuerUNITED HEALTHMarylandID302151300DescriptionMedicaidIssuerUnlistedMaryland