Modather Grain, MD
Student in an Organized Health Care Education/Training Program in Rochester, NY. Individual provider (NPI-1).
NPI number1619658705
StatusActive
Last updated in NPPESMar 24, 2026
Details
- NPI
- 1619658705
- Entity type
- Individual (NPI-1)
- Name
- Modather Grain
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2023
- Certification date
- Mar 24, 2026
- Last updated
- Mar 24, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 208M00000X | Hospitalist | TP901 | KY |
Practice location
1555 Long Pond RdRochester, NY 14626-4164
Phone 585-723-7746 · Fax 585-723-7834
Mailing address
1555 Long Pond RdRochester, NY 14626-4164
Phone 585-723-7746 · Fax 585-723-7834
Other practice locations
800 Rose St
Lexington, KY 40536-0293
Lexington, KY 40536-0293
Phone 859-323-6047
1561 Long Pond Rd Ste 206
Rochester, NY 14626-4135
Rochester, NY 14626-4135
Phone 585-368-4800 · Fax 585-368-4815
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