Individual
LAURA MICHELLE GRIESINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1004
(574) 234-4176
Mailing address
530 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1004
(574) 234-4176
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01087647A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301111891
MI
Other
Enumeration date
06/23/2017
Last updated
07/18/2022
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