Individual
RAYMOND GROTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
702 E 34TH STREET, STE 203, JOPLIN, MO 64804
(417) 523-4077
(417) 623-5171
Mailing address
PO BOX 3810, JOPLIN, MO 64803
(417) 623-4077
(417) 623-5171
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R1C31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11782
ANTHEM
MO
Enumeration date
07/03/2006
Last updated
10/18/2007
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