Individual
SUSAN E. GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3203 E OLD STONE AVE, BROOKLINE, MO 65619
(417) 269-1910
(417) 269-1916
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
105942
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105796
BCMO
MO
Enumeration date
10/12/2006
Last updated
11/05/2021
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