Individual
THEODORE JOSEPH GRIESHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
853 N CHURCH ST, STE 720B, SPARTANBURG, SC 29303-3040
(864) 560-6928
(864) 560-4413
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
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
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