Individual
MS. MYRA CRANSHAW GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2817 12TH ST NE, WASHINGTON, DC 20017
(202) 526-1030
(202) 526-0230
Mailing address
1314 RIGGS ST NW, WASHINGTON, DC 20009
(202) 667-5527
(202) 667-5561
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D0051418
MD
208000000X
Pediatrics Physician
Primary
MD21669
DC
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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