Individual
DR. GRANT MICHAEL BARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1870 BAGNELL DAM BLVD, LAKE OZARK, MO 65049-8658
(573) 365-2318
(573) 365-3009
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
DOR4GO2
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242978211
—
MO
01
—
P00303899
RAILROAD MEDICARE
MO
Enumeration date
07/14/2005
Last updated
05/05/2008
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