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Individual

DR. DIEGO HERNAN GRANJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D. MSC

Contact information

Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-7728
(417) 269-7729
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018005489
MO
207R00000X
Internal Medicine Physician
35-121780
OH
207R00000X
Internal Medicine Physician
C1-0010506
DE
207R00000X
Internal Medicine Physician
ME119339
FL
207R00000X
Internal Medicine Physician
Primary
U1020
TX
208M00000X
Hospitalist Physician
U1020
TX

Other

Enumeration date
07/14/2010
Last updated
10/04/2023
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