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Individual

DR. SAMUEL ANTHONY GRAMPSAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
747 N RUTLEDGE ST FL 5, SPRINGFIELD, IL 62702-6700
(217) 545-8000
(217) 545-7305
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2486

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036104697
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036104697
IL
01
070519
HEALTH ALLIANCE
IL
01
340019436
RAILROAD MEDICARE
IL
01
364121826 07
JOHN DEERE
IL
Enumeration date
02/13/2006
Last updated
07/29/2024
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