Individual
MICHAEL GRAINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 FAIRFIELD AVE, SUITE R102, BELLEVUE, KY 41073
(859) 431-0090
(859) 431-3168
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 431-0090
(859) 431-3168
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23828
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080092530
RAILROAD MEDICARE
KY
05
—
0993064
—
OH
05
—
64238280
—
KY
01
—
P00839903
RAILROAD MEDICARE
KY
Enumeration date
05/31/2006
Last updated
09/07/2018
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