Individual
DR. SHIRLEY GRAVENOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2636 PARK CREEK DR, GERMANTOWN, TN 38139-6556
(901) 737-7779
Mailing address
2636 PARK CREEK DR, GERMANTOWN, TN 38139-6556
(901) 737-7779
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
MD0000034785
TN
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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