Grant, William Mark

Grant, William Mark is an individual health care provider with primary practice located at 1705 E Broadway Suite 300, Columbia MO 65201-7166. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine. Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine is his primary health care specialty. Grant, William Mark can be contacted via phone (573) 817-0810.

Contact Information

Primary practice address
1705 E Broadway Suite 300 Columbia MO 65201-7166
Fax: (573) 817-1790
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X R2H91 Missouri
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X R2H91 Missouri

Profile Details

NPI number 1144299413
LBN Legal business name Grant, William Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Jul 16th, 2008 - about 16 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144299413 NPPES
Missouri MEDICAID 206649113

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