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Individual

DR. DOROTHY K GRANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 CHILDRENS PL, DIV PED GENETICS AND GENOMIC MED, SAINT LOUIS, MO 63110-1002
(314) 454-6093
(844) 965-9624
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6093
(844) 965-9624

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
R9J19
MO
207SG0202X
Clinical Biochemical Genetics Physician
R9J19
MO
208000000X
Pediatrics Physician
R9J19
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202731311
MO
Enumeration date
07/14/2006
Last updated
04/17/2025
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