Cortez Granados, Samuel Reynaldo
Cortez Granados, Samuel Reynaldo is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Endocrinology And Diabetes, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is his primary health care specialty. Cortez Granados, Samuel Reynaldo can be contacted via phone (314) 454-6051.Contact Information
Primary practice address
1 Childrens Pl Div Ped Endocrinology And Diabetes
Saint Louis MO 63110-1002
Phone: (314) 454-6051
Fax: (314) 454-6225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2020019635 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatric Endocrinology | 2080P0205X | 2020019635 | Missouri |
Profile Details
| NPI number | 1255872479 |
|---|---|
| LBN Legal business name | Cortez Granados, Samuel Reynaldo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2017 |
| Last updated | Apr 25th, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255872479 | NPPES |
| Missouri | MEDICAID | 200048695 |
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