Granneman, Nathan Lee

Granneman, Nathan Lee is an individual health care provider with primary practice located at 401 N Keene St , Columbia MO 65201-6625. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is his primary health care specialty. Granneman, Nathan Lee can be contacted via phone (573) 876-1600.

Contact Information

Primary practice address
401 N Keene St Columbia MO 65201-6625
Phone: (573) 876-1600
Fax: (573) 876-1606
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 2012023532 Missouri
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 2012023532 Missouri

Profile Details

NPI number 1689960171
LBN Legal business name Granneman, Nathan Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2011
Last updated Jan 8th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689960171 NPPES
Missouri MEDICAID 200008322

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