GUSTAVO GRANADA

KENNETT, MO
NPI1881605137
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: MO  2001023407)
Enumeration Date2006-08-11
Last Update Date2007-07-09
Business Address
Dr. GUSTAVO GRANADA MD
807 SOUTH BYP
KENNETT, MO 63857-3244
Phone number: 573-717-1332
Mailing Address
Dr. GUSTAVO GRANADA MD
PO BOX 400
NEW MADRID, MO 63869-0400
Phone number: 573-748-2404