| Nathan Lee Granneman, MD | |
|
401 N Keene St, Columbia, MO 65201-6625 | |
| (573) 876-1600 | |
| (573) 876-1606 |
| Full Name | Nathan Lee Granneman |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 14 Years |
| Location | 401 N Keene St, Columbia, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689960171 | NPI | - | NPPES |
| 200008322 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083X0100X | Preventive Medicine - Occupational Medicine | 2012023532 (Missouri) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | 2012023532 (Missouri) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Boone Hospital Center | Columbia, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boone Physician Services Llc | 6507090644 | 246 |
| Entity Name | Boone Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760893259 PECOS PAC ID: 6507090644 Enrollment ID: O20131003000535 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan Lee Granneman, MD 401 N Keene St, Columbia, MO 65201-6625 Ph: (573) 876-1600 | Nathan Lee Granneman, MD 401 N Keene St, Columbia, MO 65201-6625 Ph: (573) 876-1600 |
Dr. Janie Rhea Vale, Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 1012 Bourn Ave, Columbia, MO 65203 Phone: 573-446-2993 | |
Dr. Eddie Wayne Runde, M.D. Preventive Medicine Medicare: Medicare Enrolled Practice Location: One Hospital Dr, Columbia, MO 65212 Phone: 573-882-8091 Fax: 573-884-5994 | |
Michael Szewczyk, M.D. Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 1701 E Broadway, Suite 204, Columbia, MO 65201 Phone: 573-815-2667 | |
Dr. Richard W Stahlhut, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 194 W Green Meadows Rd, Columbia, MO 65203 Phone: 585-752-8883 | |
Dr. Robert F Thomas, MD Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 3700 I 70 Dr Se, Suite 106, Columbia, MO 65201 Phone: 573-256-7637 Fax: 573-817-3103 | |
Dr. Osman Amin, DO Preventive Medicine Medicare: Medicare Enrolled Practice Location: 2003 W Broadway, Columbia, MO 65203 Phone: 573-256-7637 Fax: 573-817-3103 | |
Chris Perrin, MS, ATC Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 1 Champions Drive Suite 230, Columbia, MO 65211 Phone: 573-882-3532 |