Individual
DR. WALTER BLAKE GRIBBEN
Active
Individual
DR. WALTER BLAKE GRIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD.42619
AL
208000000X
Pediatrics Physician
2014012620
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2014012620
MO
208M00000X
Hospitalist Physician
2014012620
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268374
—
AL
05
—
ENROLLED
—
IL
Enumeration date
05/27/2010
Last updated
07/28/2021
Update your record
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