Individual
DR. MARY ELIZABETH GRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1574 HENTHORNE DR, SUITE C, MAUMEE, OH 43537-1397
(419) 794-1407
(419) 794-1171
Mailing address
1574 HENTHORNE DR, SUITE C, MAUMEE, OH 43537-1397
(419) 794-1407
(419) 794-1171
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.090606
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2836319
—
OH
Enumeration date
02/19/2008
Last updated
02/24/2013
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