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NPI Profile for GRENADA HEMATOLOGY ONCOLOGY LLC in GRENADA, MS.
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hematology & Oncology |
207RH0003X | 11 | Physician/Internal Medicine |
| NPI # | 1710365630 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/12/2015 | |
| Last updated | 05/12/2015 - About 11 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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GRENADA HEMATOLOGY ONCOLOGY LLC