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Individual

MARK LAWRENCE GRIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 222-6389
(541) 302-0537
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD28375
OR
208M00000X
Hospitalist Physician
Primary
MD28375
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023466
OR
Enumeration date
06/10/2008
Last updated
11/11/2009
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