Individual
DR. JUSTIN GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6930
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6930
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2017021034
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Enumeration date
05/05/2014
Last updated
07/21/2022
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