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Individual

DR. PAMELLA S GRONEMEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1270 MERCANTILE DR, HIGHLAND, IL 62249-1256
(618) 651-8097
(618) 651-8097
Mailing address
1280 MERCANTILE DR, HIGHLAND, IL 62249-1256
(618) 654-8985
(618) 651-8097

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036062202
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036062202-2
IL
01
1726
BCBS
MO
01
8215239
BCBS
IL
Enumeration date
12/13/2005
Last updated
11/22/2013
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