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Individual

DR. SEAN ERIC GRAVELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
MERCY CLINIC ADULT HOSPITALIST, 621 S NEW BALLAS RD STE 112A, SAINT LOUIS, MO 63141-8252
(314) 251-6339
(314) 251-4564
Mailing address
621 S NEW BALLAS RD STE 112A, SAINT LOUIS, MO 63141-8252
(314) 251-6339
(314) 251-4564

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS013452
PA
208M00000X
Hospitalist Physician
Primary
2007011036
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OS013452
STATE LICENSE
PA
Enumeration date
11/24/2006
Last updated
03/07/2023
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