Individual
MICHAEL SCOTT GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 BUSINESS HWY 54 NORTH, ELDON, MO 65026
(573) 392-2124
(573) 392-6375
Mailing address
103 BUSINESS HWY 54 NORTH, ELDON, MO 65026
(573) 392-2124
(573) 392-6375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
108169
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010060877
RR MEDICARE
—
01
—
10582R
BLUE CROSS BLUE SHIELD
—
05
—
208705616
—
MO
01
—
3108991
CIGNA
—
01
—
389142
HEALTHLINK
—
01
—
440546366
UNITED HEALTHCARE
—
01
—
CH5818
RR MEDICARE
—
01
—
G50237
MERCY
—
Enumeration date
02/06/2006
Last updated
06/07/2012
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