Individual
THEODORE JOSEPH GRIESHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
100253
MO
207RI0200X
Infectious Disease Physician
Primary
14907
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149075
—
SC
05
—
203379219
—
MO
01
—
F25939
INDIVIDUAL
MO
01
—
P00448178
RR MEDICARE
—
Enumeration date
11/30/2005
Last updated
01/18/2023
Update your record
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