Grauke, John

Grauke, John is an individual health care provider with primary practice located at 700 S Main St , Moscow ID 83843. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Grauke, John can be contacted via phone (208) 882-4511.

Contact Information

Primary practice address
700 S Main St Moscow ID 83843
Phone: (208) 882-4511
Fax: (208) 883-6580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M6614 Idaho
Allopathic & Osteopathic Physicians / Sleep Medicine 207QS1201X M-6614 Idaho

Profile Details

NPI number 1912008079
LBN Legal business name Grauke, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 29th, 2019 - about 6 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 1912008079 NPPES
Idaho MEDICAID 003705100
Idaho Other 080067036

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