Individual
DR. MICHAEL J. GRANUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
940 E 3RD ST, #205, CASPER, WY 82601-3237
(307) 577-4260
(307) 577-4263
Mailing address
940 E 3RD ST, #205, CASPER, WY 82601-3237
(307) 577-4260
(307) 577-4263
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3007A
WY
Other
Enumeration date
04/26/2006
Last updated
07/08/2007
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